TY - JOUR
T1 - Fast Track THR
T2 - One Hospital's Experience with a 2-Day Length of Stay Protocol for Total Hip Replacement
AU - Gulotta, Lawrence V.
AU - Padgett, Douglas E.
AU - Sculco, Thomas P.
AU - Urban, Michael
AU - Lyman, Stephen
AU - Nestor, Bryan J.
PY - 2011/10
Y1 - 2011/10
N2 - Background: Current trends in total joint replacement have focused on shorter hospital stays. Purpose: This study aimed to determine if a pathway for total hip replacement (THR) with the goal of a 2-day discharge (fast track) is safe and effective compared to our traditional pathway (control). Methods: One hundred forty-nine patients undergoing unilateral, uncomplicated, THR were enrolled in an accelerated postoperative pathway and 134 were enrolled in the traditional pathway. Patients were followed prospectively and outcomes included hospital length of stay, intra- and postoperative complications, readmissions, reoperations. A statistical model was created to determine factors predictive of a 2-day discharge. Results: At 1 year, there were no differences in complications, readmissions, or reoperations. The average length of stay decreased from 4.1 to 2.6 days (p & 0.0001). In the fast track group, 58% of patients were discharged home within 2 days. Barriers to a 2-day discharge were postoperative pain, nausea, and dizziness. The only preoperative factor that was predictive of a 2-day discharge was hypertension. Conclusions: In a select group of patients, a protocol that allows for a 2-day discharge following THR is safe and effective.
AB - Background: Current trends in total joint replacement have focused on shorter hospital stays. Purpose: This study aimed to determine if a pathway for total hip replacement (THR) with the goal of a 2-day discharge (fast track) is safe and effective compared to our traditional pathway (control). Methods: One hundred forty-nine patients undergoing unilateral, uncomplicated, THR were enrolled in an accelerated postoperative pathway and 134 were enrolled in the traditional pathway. Patients were followed prospectively and outcomes included hospital length of stay, intra- and postoperative complications, readmissions, reoperations. A statistical model was created to determine factors predictive of a 2-day discharge. Results: At 1 year, there were no differences in complications, readmissions, or reoperations. The average length of stay decreased from 4.1 to 2.6 days (p & 0.0001). In the fast track group, 58% of patients were discharged home within 2 days. Barriers to a 2-day discharge were postoperative pain, nausea, and dizziness. The only preoperative factor that was predictive of a 2-day discharge was hypertension. Conclusions: In a select group of patients, a protocol that allows for a 2-day discharge following THR is safe and effective.
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U2 - 10.1007/s11420-011-9207-2
DO - 10.1007/s11420-011-9207-2
M3 - Article
C2 - 22084624
AN - SCOPUS:80054009612
SN - 1556-3316
VL - 7
SP - 223
EP - 228
JO - HSS Journal
JF - HSS Journal
IS - 3
ER -