title: Prospective study of unplanned admission to the intensive care unit after total hip arthroplasty.
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.
authors.affiliation: Department of Orthopaedic Surgery, Mayo Clinic, 200 First St SW, Gonda 14, Rm 130, Rochester, Minnesota 55905, USA.
authors.forename: Atul F
authors.initials: AF
authors.lastname: Kamath
authors.forename: Jacob T
authors.initials: JT
authors.lastname: Gutsche
authors.forename: Zev N
authors.initials: ZN
authors.lastname: Kornfield
authors.forename: Keith D
authors.initials: KD
authors.lastname: Baldwin
authors.forename: Laura M
authors.initials: LM
authors.lastname: Kosseim
authors.forename: Craig L
authors.initials: CL
authors.lastname: Israelite
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010343:Patient Admission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D014218:Triage; D055815:Young Adult
keywords: complications; intensive care unit; morbidity; total hip arthroplasty (replacement); unplanned admission