Risk assessment model used to predict discharge care after total hip and total knee arthroplasty: A population-based study.

J Orthop

Institute of Higher Education and Research in Healthcare - IUFRS, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.

Published: May 2025

Background: Transfer to a post-acute care facility or hospital readmission after total joint arthroplasty represent additional costs and increased surgical and health care resource utilization. Accurate prediction of post-acute care factors could help providers to plan the patient's discharge destination and have a positive impact on postoperative outcomes and readmission rates.

Objective: To develop a risk assessment model to predict discharge care after total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Design: A retrospective longitudinal observational study.

Settings: and participants: This study included 209 patients who underwent primary unilateral THA or TKA at a major academic medical center in Switzerland from January 2018 to December 2019.

Methods: A collection of computerized- and paper-recorded data identified the discharge destination, socio-demographic factors, comorbidities, and other factors related to the patient. Univariate and multivariate analyses were performed to describe the predictors of post-surgical discharge destinations.

Results: The characteristics associated with post-acute care after primary unilateral THA or TKA were the absence of a caregiver, advanced age, female gender, presence of walking aids, high ASA score, and comorbidity severity. A prediction model demonstrated that these six characteristics were associated 52 % with discharge to a post-acute care destination.

Conclusions: This study allowed us to identify predictors of discharge to a post-surgical destination. Predictive models can be efficiently used to better predict which patients are predisposed to post-acute care after hospital discharge. Further studies are needed to determine the optimal criteria for different destinations.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546128PMC
http://dx.doi.org/10.1016/j.jor.2024.10.031DOI Listing

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