Background: Despite increased efforts toward patient optimization, some patients have undocumented conditions that can affect costs and quality metrics for institutions and physicians. This study evaluates the effect of documented and undocumented psychiatric conditions on length of stay (LOS) and discharge disposition following total hip arthroplasty (THA).
Methods: A retrospective review of all primary THAs from 2015 to 2020 at a high-volume academic orthopedic specialty hospital was conducted. Patients were separated into 3 cohorts: patients with a documented psychiatric diagnosis (+Dx), patients without a documented psychiatric diagnosis but with an actively prescribed psychiatric medication (-Dx), and patients without a psychiatric diagnosis or medication (control). Patient demographics, LOS, and discharge disposition were assessed.
Results: A total of 5309 patients were included; 3048 patients had no recorded psychiatric medications (control); 2261 patients took at least 1 psychiatric medication, of which 1513 (65.9%) and 748 (34.1%) patients were put in the -Dx and +Dx cohorts, respectively. American Society of Anesthesiologists class differed between groups (P < .001). The -Dx and +Dx groups had increased LOS (3.15 ± 2.37 [75.6 ± 56.9] and 3.12 ± 2.27 [74.9 ± 54.5] vs 2.42 ± 1.70 [57.6 ± 40.8] days (hours), P < .001) and were more likely to be discharged to a secondary facility (23.0% and 21.7% vs 13.8%, P < .001) than the control group. Outcomes did not significantly differ between the -Dx and +Dx cohorts.
Conclusion: Most THA patients' psychiatric diagnoses were not documented. The presence of psychiatric medications was associated with longer LOS and a greater likelihood of discharge to secondary facilities. This has implications for both cost and quality metrics. Review of medications can help identify and optimize these patients before surgery.
Level Iii Evidence: Retrospective Cohort Study.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.arth.2021.11.040 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Creating a predictive model and online calculator for high-value care outcomes following glioblastoma resection: incorporating neighborhood socioeconomic status index.
J Neurooncol
January 2025
Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD, 21287, USA.
Purpose: Social determinants of health including neighborhood socioeconomic status, have been established to play a profound role in overall access to care and outcomes in numerous specialized disease entities. To provide glioblastoma multiforme (GBM) patients with high-quality care, it is crucial to identify predictors of hospital length of stay (LOS), discharge disposition, and access to postoperative adjuvant chemoradiation. In this study, we incorporate a novel neighborhood socioeconomic status index (NSES) and develop three predictive algorithms for assessing post-operative outcomes in GBM patients, offering a tool for preoperative risk stratification of GBM patients.
View Article and Find Full Text PDFGeographic Variation in Inpatient Rehabilitation Outcomes After Traumatic Brain Injury.
J Head Trauma Rehabil
January 2025
Author Affiliations: Department of Orthopaedic Surgery and Rehabilitation, Wake Forest School of Medicine, Winston-Salem, North Carolina (Dr Darji); Department of Physical Medicine and Rehabilitation, Atrium Health Carolinas Rehabilitation, Charlotte, North Carolina (Dr Darji); Division of Physical Medicine and Rehabilitation, Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, Texas (Dr Zhang); Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, Massachusetts (Drs Goldstein, Shih, Iaccarino, Schneider, and Zafonte); Massachusetts General Hospital, Boston, Massachusetts (Drs Shih, Iaccarino, and Zafonte); and Brigham and Women's Hospital, Boston, Massachusetts (Dr Zafonte).
Objective: To determine whether regional variations exist in functional outcomes of patients with traumatic brain injury (TBI) admitted to inpatient rehabilitation facilities (IRFs) across the United States, while controlling for demographic and clinical variables.
Setting: Inpatient rehabilitation facilities (IRFs) across 4 U.S.
Rate and yield of imaging for acute pyelonephritis in the emergency department: A retrospective cohort study.
Emerg Med Australas
February 2025
Emergency Service, Alfred Health, Melbourne, Victoria, Australia.
Objectives: The role of imaging in acute pyelonephritis (APN) in the ED is poorly understood, with variability among clinical guidelines for when patients should be imaged, and the modality of imaging. The objective of this study was to identify the proportion of patients with APN being imaged, the proportion abnormal findings, and the association between abnormal imaging and discharge disposition.
Methods: A single-centre retrospective review of patients with a discharge diagnosis of APN at an adult tertiary referral hospital over a 5-year period (2018-2022) was conducted.
Living alone predicts non-home discharge post elective hip arthroplasty: A matched-pair cohort study.
PLoS One
January 2025
Department of Anesthesiology, University of Virginia Health, Charlottesville, VA, United States of America.
The impact of home support and interaction with family members on recovery and perioperative outcomes remains unclear. We determined whether living alone was predictive of discharge disposition following total hip arthroplasty (THA). Data were from American College of Surgeons National Surgical Quality Improvement Program participating hospitals in 2021.
View Article and Find Full Text PDFAssociation of Safety-Net hospital status and hospital outcomes following ACDF or PCDF for CSM.
J Clin Neurosci
December 2024
Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, NY, USA.
Introduction: Safety net hospitals (SNH) serve a large proportion of patients with Medicaid or without insurance. However, few prior studies have addressed the impact of SNH status on outcomes following anterior cervical discectomy and fusion (ACDF) or posterior cervical decompression and fusion (PCDF) for cervical spondylotic myelopathy (CSM). The aim of this study was to assess the association between SNH status outcomes following ACDF or PCDF for CSM.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!