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PMID- 29292337
OWN - NLM
STAT- MEDLINE
DCOM- 20180104
LR  - 20180104
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 1 Supple A
DP  - 2018 Jan
TI  - The outpatient total hip arthroplasty : a paradigm change.
PG  - 31-35
LID - 10.1302/0301-620X.100B1.BJJ-2017-0514.R1 [doi]
AB  - AIMS: To examine incidence of complications associated with outpatient total hip 
      arthroplasty (THA), and to see if medical comorbidities are associated with
      complications or extended length of stay. PATIENTS AND METHODS: From June 2013 to
      December 2016, 1279 patients underwent 1472 outpatient THAs at our free-standing 
      ambulatory surgery centre. Records were reviewed to determine frequency of
      pre-operative medical comorbidities and post-operative need for overnight stay
      and complications which arose. RESULTS: In 87 procedures, the patient stayed
      overnight for 23-hour observation, with 39 for convenience reasons and 48 (3.3%) 
      for medical observation, most frequently urinary retention (13), obstructive
      sleep apnoea (nine), emesis (four), hypoxia (four), and pain management (six).
      Five patients (0.3%) experienced major complications within 48 hours, including
      three transferred to an acute facility; there was one death. Overall complication
      rate requiring unplanned care was 2.2% (32/1472). One or more major comorbidities
      were present in 647 patients (44%), including previous coronary artery disease
      (CAD; 50), valvular disease (nine), arrhythmia (219), thromboembolism history
      (28), obstructive sleep apnoea (171), chronic obstructive pulmonary disease
      (COPD; 124), asthma (118), frequent urination or benign prostatic hypertrophy
      (BPH; 217), or mild chronic renal insufficiency (11). CONCLUSION: The presence of
      these comorbidities was not associated with medical or surgical complications.
      However, presence of one or more major comorbidity was associated with an
      increased risk of overnight observation. Specific comorbidities associated with
      increased risk were CAD, COPD, and frequent urination/BPH. Outpatient THA is safe
      for a large proportion of patients without the need for a standardised risk
      assessment score. Risk of complications is not associated with presence of
      medical comorbidities. Cite this article: Bone Joint J 2018;100-B(1 Supple
      A):31-5.
CI  - (c)2018 The British Editorial Society of Bone and Joint Surgery.
FAU - Berend, K R
AU  - Berend KR
AD  - Joint Implant Surgeons, 7277 Smith's Mill Road, Suite 200, New Albany, Ohio
      43054, USA.
FAU - Lombardi, A V Jr
AU  - Lombardi AV Jr
AD  - Joint Implant Surgeons, 7277 Smith's Mill Road, Suite 200, New Albany, Ohio
      43054, USA.
FAU - Berend, M E
AU  - Berend ME
AD  - Midwest Centre for Joint Replacement , 6920 Gatwick Drive, Suite 200,
      Indianapolis, Indiana 46241, USA.
FAU - Adams, J B
AU  - Adams JB
AD  - Joint Implant Surgeons, 7277 Smith's Mill Road, Suite 200, New Albany, Ohio
      43054, USA.
FAU - Morris, M J
AU  - Morris MJ
AD  - Joint Implant Surgeons, 7277 Smith's Mill Road, Suite 200, New Albany, Ohio
      43054, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Ambulatory Surgical Procedures
MH  - Arthroplasty, Replacement, Hip/*methods
MH  - Comorbidity
MH  - Female
MH  - Humans
MH  - Incidence
MH  - *Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment (Health Care)
MH  - Postoperative Complications/epidemiology/*etiology
MH  - Risk Factors
OTO - NOTNLM
OT  - Ambulatory surgery centre
OT  - Complications
OT  - Length of stay
OT  - Medical co-morbidity
OT  - Outpatient
OT  - Total hip arthroplasty
EDAT- 2018/01/03 06:00
MHDA- 2018/01/05 06:00
CRDT- 2018/01/03 06:00
PHST- 2017/04/28 00:00 [received]
PHST- 2017/07/07 00:00 [accepted]
PHST- 2018/01/03 06:00 [entrez]
PHST- 2018/01/03 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
AID - 100-B/1_Supple_A/31 [pii]
AID - 10.1302/0301-620X.100B1.BJJ-2017-0514.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Jan;100-B(1 Supple A):31-35. doi:
      10.1302/0301-620X.100B1.BJJ-2017-0514.R1.