Is Outpatient Total Hip Arthroplasty Safe?

Area of Science:

• Orthopedic Surgery
• Patient Outcomes Research
• Health Services Research

Background:

• Safety data for outpatient total hip arthroplasty (THA) is limited.
• Understanding risks associated with same-day discharge THA is crucial for patient selection and care pathways.

Purpose of the Study:

• To evaluate the safety and 30-day adverse event rates of outpatient THA compared to short-stay inpatient THA.
• To determine if outpatient THA increases the risk of readmission or complications.

Main Methods:

• Retrospective review of prospectively collected data from the American College of Surgeons National Surgical Quality Improvement Program Database (2005-2014).
• Patients undergoing THA were categorized into outpatient (LOS 0 days) and inpatient (LOS 1-5 days) groups, with extended LOS excluded.
• Propensity score matching was used to control for baseline differences, followed by multivariate Poisson regression to compare adverse events and readmission rates.

Main Results:

• A total of 63,844 THA patients were analyzed; 0.66% were outpatients.
• Outpatients were generally younger, male, and had fewer comorbidities.
• After propensity score matching, outpatients had significantly lower rates of blood transfusion (3.69% vs 9.06%) and no increased risk for other evaluated adverse events.

Conclusions:

• Outpatient THA is not associated with a greater risk of 30-day adverse events or readmission compared to inpatient THA when appropriately selected.
• The findings support the consideration of outpatient THA for carefully selected patients based on general health outcome measures.