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Predictive factors for discharge destination after total hip arthroplasty
Institution:1. Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan;2. Department of Orthopaedic Surgery, Fukuoka Sanno Hospital, 3-6-45, Momochihama, Sawara-ku, Fukuoka 814-0001, Japan;1. College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia;2. King Abdullah International Medical Research Center, Jeddah, Saudi Arabia;3. Department of Surgery/Orthopedic Section, King Abdulaziz Medical City, Jeddah, Saudi Arabia;1. Department of Orthopaedic Surgery, Aichi Medical University, Japan;2. Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, Japan;3. Department of Orthopaedic Surgery, Asahi Hospital, Japan;4. Department of Orthopaedic Surgery, Hiroshima University, Japan
Abstract:BackgroundThis study aimed to investigate factors affecting discharge to an inpatient rehabilitation facility or home following total hip arthroplasty, using a clinical pathway in Japan.MethodsFive hundred hips with osteoarthritis who underwent unilateral total hip arthroplasty at our institution, with no deviation from the pathway, were included in this retrospective study. The variables were examined by univariate analysis. Multivariate logistic regression analysis was used to identify the independent factors that influenced the discharge outcome.ResultsFour hundred and thirty-four hips were discharged home directly, and 66 were discharged to an inpatient rehabilitation facility. Patients discharged to an inpatient rehabilitation facility were significantly older, shorter, lighter, and more likely to live alone. Additionally, the preoperative clinical score was significantly lower in the inpatient rehabilitation facility Group for all items. Logistic regression analysis showed a significant association between being discharged to an inpatient rehabilitation facility and higher age odds ratio 3.87, 95% confidence interval 2.03–7.38, P < 0.001], lower total score in the preoperative Japanese Orthopaedic Association hip score odds ratio 2.42, 95% confidence interval 1.38–4.23, P = 0.002] and living alone odds ratio 1.84, 95% confidence interval 1.01–3.35, P = 0.046].ConclusionsIn this study, age, the preoperative Japanese Orthopaedic Association hip score, and living arrangement impacted the discharge destination after THA.
Keywords:Total hip arthroplasty  Factors affecting discharge destination  Clinical pathways
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