Risk Factors for Prolonged Time to Discharge in Total Hip Patients Performed in an Ambulatory Surgery Center due to Complaints of the Inability to Void

Mathew, Matt; Ragsdale, Tyler D.; Pharr, Zachary K.; Rider, Carson M.; Mihalko, William M.; Toy, Patrick C.

doi:10.1016/j.arth.2021.06.010

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…Even with experienced orthopedic surgeons, there are still a considerable number of patients with postoperative complications. Common complications include traumatic arthritis and osteonecrosis of the femoral head [ 3 ]. When patients have severe hip pain and limited function, surgical intervention is often needed because hip arthrodesis will lead to a series of problems, such as the loss of hip joint function and the change of spinal force; it has rarely been adopted, and joint replacement is advocated.…”

Section: Introductionmentioning

confidence: 99%

Logistic Regression Analysis of Risk Factors and Improvement of Clinical Treatment of Traumatic Arthritis after Total Hip Arthroplasty (THA) in the Treatment of Acetabular Fractures

Zhang

Feng²

2022

Computational and Mathematical Methods in Medicine

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Objective. Logistic regression was adopted to analyze the risk factors of traumatic arthritis after total hip arthroplasty (THA) in the treatment of acetabular fractures, and the clinical treatment was enhanced. Methods. A total of 200 patients with acetabular fractures treated in our hospital from February 2019 to April 2021 were enrolled for THA. According to the occurrence of traumatic arthritis after operation, the patients were divided into control group and study group. The control group was patients without traumatic arthritis ( n = 165 ), and the study group was patients with traumatic arthritis after operation ( n = 35 ). The general data were analyzed, the risk factors of traumatic arthritis after THA for acetabular fractures were analyzed by logistic regression, and the clinical treatment methods were promoted. Results. First of all, there exhibited no significant difference in the general data such as sex, age, medical history, and operation site ( P > 0.05 ). There were significant differences in the general data of whether the patients had a job, rehabilitation exercise, and osteoarthritis before operation ( P < 0.05 ). Secondly, we compared the curative effects between two groups. The effective rate in the study group was higher compared to the control group ( P < 0.05 ). After treatment, the Harris hip function score of the study group at discharge, 1 month, 3 months, and 6 months after discharge was higher compared to that of the control group ( P < 0.05 ). The incidence of postoperative complications in the study group was significantly higher compared to that in the control group ( P < 0.05 ). The presence of osteoarthritis, curative effect, poor reduction of fracture, injury of articular cartilage, entry of internal fixation into the joint, avascular necrosis of the femoral head, and infection before operation were significantly correlated with traumatic arthritis after THA in the treatment of acetabular fractures ( P < 0.05 ). Logistic regression analysis indicated that poor reduction, curative effect, articular cartilage injury, entry of internal fixation into the joint, avascular necrosis of the femoral head, infection, and preoperative osteoarthritis were the risk factors of traumatic arthritis after THA in the treatment of acetabular fractures ( P < 0.05 ). Conclusion. Poor fracture reduction, curative effect, articular cartilage injury, internal fixation into the joint, avascular necrosis of the femoral head, infection, and the presence of osteoarthritis before operation are the risk factors of traumatic arthritis after THA in the treatment of acetabular fractures. When performing THA for patients with acetabular fracture, attention should be paid to the presence of osteoarthritis before operation, and for those with poor curative effect, attention should be paid to the occurrence of poor fracture reduction, articular cartilage injury, internal fixation into the joint, avascular necrosis of the femoral head, and combined infection, and timely intervention measures should be taken to reduce the risk of traumatic arthritis after operation.

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Section: Introductionmentioning

confidence: 99%

Logistic Regression Analysis of Risk Factors and Improvement of Clinical Treatment of Traumatic Arthritis after Total Hip Arthroplasty (THA) in the Treatment of Acetabular Fractures

Zhang

Feng²

2022

Computational and Mathematical Methods in Medicine

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“…Males made up 45% of the POUR population, versus 42.5% of the non-POUR population. The mean ages of POUR and non-POUR patients were 67.6 years (58.9 41 to 79.7 18 ) and 65.4 years (55.4 41 to 78.6 29 ), respectively. POUR was diagnosed based on three methods in the included studies: sonography postoperative catheterization use, and patient symptoms ( Table I ).…”

Section: Resultsmentioning

confidence: 99%

Risk factors of postoperative urinary retention following total hip and knee arthroplasty

Azarboo,

Ghaseminejad-Raeini,

Teymoori-Masuleh

et al. 2024

Bone Jt Open

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AimsThe aim of this meta-analysis was to determine the pooled incidence of postoperative urinary retention (POUR) following total hip and knee arthroplasty (total joint replacement (TJR)) and to evaluate the risk factors and complications associated with POUR.MethodsTwo authors conducted searches in PubMed, Embase, Web of Science, and Scopus on TJR and urinary retention. Eligible studies that reported the rate of POUR and associated risk factors for patients undergoing TJR were included in the analysis. Patient demographic details, medical comorbidities, and postoperative outcomes and complications were separately analyzed. The effect estimates for continuous and categorical data were reported as standardized mean differences (SMDs) and odds ratios (ORs) with 95% CIs, respectively.ResultsA total of 31 studies were included in the systematic review. Of these, 29 studies entered our meta-analysis, which included 3,273 patients diagnosed with POUR and 11,583 patients without POUR following TJR. The pooled incidence of POUR was 28.06%. Demographic risk factors included male sex (OR 1.81, 95% CI 1.26 to 2.59), increasing age (SMD 0.16, 95% CI 0.04 to 0.27), and American Society of Anesthesiologists grade 3 to 4 (OR 1.39, 95% CI 1.10 to 1.77). Patients with a history of benign prostatic hyperplasia (OR 1.99, 95% CI 1.41 to 2.83) and retention (OR 3.10, 95% CI 1.58 to 6.06) were more likely to develop POUR. Surgery-related risk factors included spinal anaesthesia (OR 1.44, 95% CI 1.19 to 1.74) and postoperative epidural analgesia (OR 2.82, 95% CI 1.65 to 4.82). Total hip arthroplasty was associated with higher odds of POUR compared to total knee arthroplasty (OR 1.10, 95% CI 1.02 to 1.20). Postoperatively, POUR was associated with a longer length of stay (SMD 0.21, 95% CI 0.02 to 0.39).ConclusionOur meta-analysis demonstrated key risk variables for POUR following TJR, which may assist in identifying at-risk patients and direct patient-centered pathways to minimize this postoperative complication.Cite this article: Bone Jt Open 2024;5(7):601–611.

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“…Commonly described limiting factors for failed early discharge are; not showing robust stable vital signs, not being able to control of pain and PONV with oral medications not able to ambulation unaided and, not being adequately cognitive restored to manage self-care, patient and caregivers uncertainty to leave hospital [20 ▪▪ ,64,65]. Not being able to urinate and/or urinary retention is also a frequent failure course [66,67 ▪ ,68 ▪ ].…”

Section: Logisticsmentioning

confidence: 99%

Ambulatory anesthesia and discharge: an update around guidelines and trends

Rohi

Olofsson

Jakobsson

2022

Current Opinion in Anaesthesiology

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Purpose of reviewProvide an oversight of recent changes in same-day discharge (SDD) of patient following surgery/anesthesia.Recent findingsEnhanced recovery after surgery pathways in combination with less invasive surgical techniques have dramatically changed perioperative care. Preparing and optimizing patients preoperatively, minimizing surgical trauma, using fast-acting anesthetics as well as multimodal opioid-sparing analgesia regime and liberal prophylaxis against postoperative nausea and vomiting are basic cornerstones. The scope being to maintain physiology and minimize the impact on homeostasis and subsequently hasten and improve recovery.SummaryThe increasing adoption of enhanced protocols, including the entire perioperative care bundle, in combination with increased use of minimally invasive surgical techniques have shortened hospital stay. More intermediate procedures are today transferred to ambulatory pathways; SDD or overnight stay only. The traditional scores for assessing discharge eligibility are however still valid. Stable vital signs, awake and oriented, able to ambulate with acceptable pain, and postoperative nausea and vomiting are always needed. Drinking and voiding must be acknowledged but mandatory. Escort and someone at home the first night following surgery are strongly recommended. Explicit information around postoperative care and how to contact healthcare in case of need, as well as a follow-up call day after surgery, are likewise of importance. Mobile apps and remote monitoring are techniques increasingly used to improve postoperative follow-up.

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Risk Factors for Prolonged Time to Discharge in Total Hip Patients Performed in an Ambulatory Surgery Center due to Complaints of the Inability to Void

Cited by 9 publications

References 22 publications

Logistic Regression Analysis of Risk Factors and Improvement of Clinical Treatment of Traumatic Arthritis after Total Hip Arthroplasty (THA) in the Treatment of Acetabular Fractures

Logistic Regression Analysis of Risk Factors and Improvement of Clinical Treatment of Traumatic Arthritis after Total Hip Arthroplasty (THA) in the Treatment of Acetabular Fractures

Risk factors of postoperative urinary retention following total hip and knee arthroplasty

Ambulatory anesthesia and discharge: an update around guidelines and trends

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