title: [Clinical audits of the procedure of the total hip arthroplasty and its impact on the improvement of the quality care].
abstract: BACKGROUND
  Clinical audits are critical and systematic quality analysis of medical care. Total hip arthroplasty (THA) is a routine practice and cost-effective, although there is little information on the quality of care of it.
  
  
  OBJECTIVE
  To evaluate the impact of a clinical audit cycle in the quality of care in the primary THA procedures for non-traumatic cause.
  
  
  METHODS
  A series of two audits (first audit in 2005 and second one in 2007) were performed. Patients of both sexes with non-traumatic primary THA and with a follow-up of 6 months were included. Time (days) in hospital stay and the rate (percentage) of readmissions were used as indicators of management; and as indicators of clinical practice: the index (percentage) of dislocation and the rate (percentage) of infection. Both audits were compared with respect to these indicators.
  
  
  RESULTS
  A total of 160 patients (79 and 81, first and second audit respectively) were analysed. Management indicators: median (range) of hospital stay was 8 (7-78) and 7 (6-16), p<0.001, and the percentage of readmissions 5% (4/79) and 0 (0/81), p=0.057. Indicators of clinical practice: the rate of dislocation was 8% (6/79) and 0 (0/81), p=0.013, and the rate of infection 1% (1/79) and 1% (1/81), p=1. A multivariate analysis did not find other factors related to these indicators.
  
  
  CONCLUSIONS
  The implementation of a clinical audit cycle has improved the quality of care of primary THA procedures for non-traumatic cause.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona, España. rafael.monte.secades@sergas.es
authors.forename: J C
authors.initials: JC
authors.lastname: Valdés
authors.forename: M
authors.initials: M
authors.lastname: Videla
authors.forename: M
authors.initials: M
authors.lastname: Lafuente
authors.forename: E
authors.initials: E
authors.lastname: Henere
authors.forename: A
authors.initials: A
authors.lastname: Poal-Manresa
authors.forename: P
authors.initials: P
authors.lastname: Madrid
authors.forename: A
authors.initials: A
authors.lastname: Benet
authors.forename: S
authors.initials: S
authors.lastname: Videla
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000592:standards / Q000706:statistics & numerical data*; D001363:Awards and Prizes; D015897:Comorbidity; D005260:Female; D006617:Hip Dislocation / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D015207:Osteoarthritis, Hip / Q000601:surgery; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D016459:Prosthesis-Related Infections / Q000453:epidemiology; D058996:Quality Improvement; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology