The Impact of Patient Resilience on Discharge After Total Hip Arthroplasty.

Background: Patients who undergo total hip arthroplasty (THA) require resilience to recover and resume daily functions. Increased resilience may be an important factor for achieving improved outcomes. The purpose of this study is to examine the impact of resilience on time to discharge and on early patient-reported outcomes following primary THA.

Methods: A retrospective review of patients who underwent primary THAs and completed the Brief Resilience Scale (BRS) was conducted from 2020 to 2021 at an urban, academic hospital. Patients were separated into 3 cohorts based on BRS score: low (1-2.99), normal (3-4.30), and high (4.31-5) resilience. Demographics, participation in same-day discharge (SDD) program, length of stay (LOS), and preoperative and 3-month postoperative scores on the Hip Disability and Osteoarthritis Outcome Score Joint Replacement (HOOS JR) were assessed. SDD patients were excluded from LOS analysis.

Results: A total of 393 patients were included. Compared to low resilience patients, odds of being enrolled in SDD program were 1.49 and 3.01 times higher (P = .01) and 3-month HOOS JR scores improved by 4.7% and 11.7% (P = .03) for normal and high resilience patients, respectively. As resilience increased from low to normal to high in non-SDD patients, LOS significantly decreased (53.27 ± 51.92 vs 38.70 ± 28.03 vs 25.64 ± 14.48 hours, respectively; P = .001).

Conclusion: Increased resilience is positively associated with likelihood of SDD participation or decreased LOS. Increased resilience was associated with increased HOOS JR scores at 3 months, although this did not reach the minimal clinically important difference. The BRS may be a useful tool for predicting patients who can successfully participate in SDD or predicting LOS after primary THA.