Decreasing length of stay after total joint arthroplasty: Effect on referrals to rehabilitation units

Does Preoperative American Society of Anesthesiologists Score Relate to Complications After Total Shoulder Arthroplasty?

“…This finding is supported by previous studies that have shown that patients with a high ASA score are more likely to require a prolonged hospitalization or intensive care unit stay [7,8,17,29], have higher rates of discharge to rehabilitation or skilled nursing facilities [15], and incur increased hospital costs [46,53]. The causes of this increased length of stay are speculative but may be the result of intraoperative factors, such as length of surgery, red blood cell transfusions [7], or baseline functional status [17].…”

“…The retrospective cohort included all patients who had a TSA or reverse TSA as a primary or revision procedure by the senior author (EGM) from November 1999 through July 2011; patients undergoing primary hemiarthroplasty for fracture were excluded. Of the 485 procedures, 33 were excluded: 17 because there was no ASA score recorded preoperatively and 16 because the patients had less than the minimum 6-month followup secondary to death (one) or loss to followup (15). Of the 16 patients, nine were seen in the clinic for a 3-month postoperative visit; no medical or surgical complications were reported at that time.…”

“…High ASA scores have been shown to be associated with an increased risk of medical complications [30,36], prosthesis dislocation [2,23,26,28], infection [4,9,25,27,33,41,43,45,50,57], prolonged hospital stay [6,17,29], and discharge to a rehabilitation service [15] after hip and knee arthroplasties.…”

Decreased Length of Stay After TKA Is Not Associated With Increased Readmission Rates in a National Medicare Sample

“…Some suggest reductions in postoperative LOS in TKA are an effective cost reducer and do not increase postoperative adverse events (AEs) [9]. However, there are concerns that reductions in LOS may affect other postoperative outcomes, possibly causing prolonged stays in rehabilitation units, increasing adverse events after discharge, or increasing the need for readmission [6,22].…”

Factors Associated with the Recovery of Walking Ability Following Total Hip Arthroplasty

“…The aim of early physiotherapy is to maximize patients' functionality and independence in performing activities of daily living (ADL) and to prevent complications such as deep vein thrombosis, pulmonary embolism, muscle atrophy, and hip dislocation 1) . Prediction of postoperative ambulatory ability is critical for determining the length of hospital stay, and can also aid patients in developing appropriate expectations in terms of regaining the ability to perform ADL in the early postoperative stage of THA.…”