Prospective Study of Unplanned Admission to the Intensive Care Unit after Total Hip Arthroplasty |
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Authors: | Atul F Kamath Jacob T Gutsche Zev N Kornfield Keith D Baldwin Laura M Kosseim Craig L Israelite |
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Institution: | 1. Department of Orthopaedic Surgery, Mayo Clinic, 200 First St SW, Gonda 14, Rm 130, Rochester, Minnesota;2. Department of Anesthesia and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;3. Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;4. Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania |
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Abstract: | The morbidity associated with elective total hip arthroplasty (THA) may result in intensive care unit (ICU) admission. A total of 175 consecutive THA patients were prospectively triaged to either an ICU bed or routine post-operative floor according to admission criteria based on a prior published study of 1259 THA patients. Primary end points were a reduction in unplanned ICU admission, as well as major complications. With our triage model, the rate of unplanned ICU admissions dropped from 7.1% to 2.2% (P = 0.013). The as-treated odds of unplanned admission pre- versus post-intervention were 3.2 (1.2, 10.6). The complication rate fell from 12.5% to 2%, and the mortality index decreased from 4.77 to 1.62. Triage according to selected risk factors affects a reduction in unplanned ICU admissions and major complications after THA. |
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Keywords: | intensive care unit unplanned admission complications morbidity total hip arthroplasty (replacement) |
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