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Published on: September 7, 2022
Prospective study of unplanned admission to the intensive care unit after total hip arthroplasty
Atul F Kamath1, Jacob T Gutsche, Zev N Kornfield
1Department of Orthopaedic Surgery, Mayo Clinic, 200 First St SW, Gonda 14, Rm 130, Rochester, Minnesota 55905, USA.
Abstract:
The morbidity associated with elective total hip arthroplasty (THA) may result in intensive care unit (ICU) admission. A total of 175 consecutive THA patients were prospectively triaged to either an ICU bed or routine post-operative floor according to admission criteria based on a prior published study of 1259 THA patients. Primary end points were a reduction in unplanned ICU admission, as well as major complications. With our triage model, the rate of unplanned ICU admissions dropped from 7.1% to 2.2% (P=0.013). The as-treated odds of unplanned admission pre- versus post-intervention were 3.2 (1.2, 10.6). The complication rate fell from 12.5% to 2%, and the mortality index decreased from 4.77 to 1.62. Triage according to selected risk factors affects a reduction in unplanned ICU admissions and major complications after THA.