title: Patient expectation is the most important predictor of discharge destination after primary total joint arthroplasty.
abstract: The purpose of this study was to identify preoperative predictors of discharge destination after total joint arthroplasty. A retrospective study of three hundred and seventy-two consecutive patients who underwent primary total hip and knee arthroplasty was performed. The mean length of stay was 2.9 days and 29.0% of patients were discharged to extended care facilities. Age, caregiver support at home, and patient expectation of discharge destination were the only significant multivariable predictors regardless of the type of surgery (total knee versus total hip arthroplasty). Among those variables, patient expectation was the most important predictor (P < 0.001; OR 169.53). The study was adequately powered to analyze the variables in the multivariable logistic regression model, which had a high concordance index of 0.969.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Mohamad J
authors.initials: MJ
authors.lastname: Halawi
authors.affiliation: Duke University School of Medicine, Durham, North Carolina.
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: Vovos
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina.
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Green
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Wellman
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: David E
authors.initials: DE
authors.lastname: Attarian
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bolognesi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000523:psychology / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities
keywords: arthroplasty; discharge destination; hip; knee; patient expectation; preoperative predictors