title: Rapid recovery protocols for primary total hip arthroplasty can safely reduce length of stay without increasing readmissions.
abstract: We sought to investigate the impact of incremental perioperative recovery protocol changes on hospital LOS and readmission rates associated with primary THAs. A total of 1751 cases were assigned to one of four protocol cohorts across 13 years: traditional, enhanced pain management, early mobility, and rapid recovery (RR). LOS significantly decreased between sequential eras and by 52% between the traditional and RR pathways (IRR=0.48; 95% CI 0.44, 0.53; P<0.0001) without an overall increase in 30-day readmission rates (P=0.13). The odds of readmission for THAs performed under the RR pathway were almost one-third those of the traditional era (OR=0.36; 95% CI 0.14, 0.93; P=0.04). Accelerated clinical care protocols should be considered for most patients undergoing primary THA.
authors: Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, Missouri. Electronic address: jeffrey.stambough@gmail.com.
authors: Jeffrey B
authors: JB
authors: Stambough
authors: Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, Missouri.
authors: Ryan M
authors: RM
authors: Nunley
authors: Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, Missouri.
authors: Madelyn C
authors: MC
authors: Curry
authors: Washington University School of Medicine, Division of Biostatistics, St. Louis, Missouri.
authors: Karen
authors: K
authors: Steger-May
authors: Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, Missouri.
authors: John C
authors: JC
authors: Clohisy
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation / Q000592:standards; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D061214:Patient Safety; D019990:Perioperative Care / Q000592:standards; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: THA; length of stay; perioperative protocols; rapid recovery; readmissions