Iwata Hirokazu, Sakata Kosuke, Matsuoka Hozo, Sogo Eiji, Nanno Katsuhiko, Kuroda Sanae, Nakamura Shigeko, Hayashi Junzo, Nakai Tsuyoshi
Itami City Hospital, Department of Orthopaedic Surgery, Japan.
Itami City Hospital, Department of Orthopaedic Surgery, Japan.
J Orthop Sci. 2023 Jul;28(4):802-805. doi: 10.1016/j.jos.2022.05.005. Epub 2022 Jun 9.
This study aimed to investigate factors affecting discharge to an inpatient rehabilitation facility or home following total hip arthroplasty, using a clinical pathway in Japan.
Five hundred hips with osteoarthritis who underwent unilateral total hip arthroplasty at our institution, with no deviation from the pathway, were included in this retrospective study. The variables were examined by univariate analysis. Multivariate logistic regression analysis was used to identify the independent factors that influenced the discharge outcome.
Four hundred and thirty-four hips were discharged home directly, and 66 were discharged to an inpatient rehabilitation facility. Patients discharged to an inpatient rehabilitation facility were significantly older, shorter, lighter, and more likely to live alone. Additionally, the preoperative clinical score was significantly lower in the inpatient rehabilitation facility Group for all items. Logistic regression analysis showed a significant association between being discharged to an inpatient rehabilitation facility and higher age [odds ratio 3.87, 95% confidence interval 2.03-7.38, P < 0.001], lower total score in the preoperative Japanese Orthopaedic Association hip score [odds ratio 2.42, 95% confidence interval 1.38-4.23, P = 0.002] and living alone [odds ratio 1.84, 95% confidence interval 1.01-3.35, P = 0.046].
In this study, age, the preoperative Japanese Orthopaedic Association hip score, and living arrangement impacted the discharge destination after THA.
本研究旨在利用日本的临床路径，调查影响全髋关节置换术后患者出院至住院康复机构或家中的因素。
本回顾性研究纳入了在我院接受单侧全髋关节置换术且未偏离路径的500例骨关节炎患者的髋关节。通过单因素分析检查变量。采用多因素逻辑回归分析确定影响出院结局的独立因素。
434例髋关节直接出院回家，66例出院至住院康复机构。出院至住院康复机构的患者年龄显著更大、身高更矮、体重更轻，且更有可能独居。此外，住院康复机构组所有项目的术前临床评分均显著更低。逻辑回归分析显示，出院至住院康复机构与更高年龄[比值比3.87，95%置信区间2.03 - 7.38，P < 0.001]、术前日本骨科协会髋关节评分总分更低[比值比2.42，95%置信区间1.38 - 4.23，P = 0.002]以及独居[比值比1.84，95%置信区间1.01 - 3.35，P = 0.046]之间存在显著关联。
在本研究中，年龄、术前日本骨科协会髋关节评分以及居住安排影响了全髋关节置换术后的出院目的地。
