van Kampen Derk A, de Vries Lieke, Jan Hillen Robert, La Guardia Paulo, van Beek Rienk
Dijklander Hospital - Orthopedic surgery, Hoorn, Netherlands.
Shoulder Elbow. 2023 Sep;15(1 Suppl):80-86. doi: 10.1177/17585732221113503. Epub 2022 Jul 27.
Shoulder arthroplasty is mostly performed as an inpatient procedure. Same-day discharge arthroplasty has shown positive results in hip and knee surgery. Primary objective of this study was to investigate whether a safe and satisfactory same-day discharge (SDD) can be predicted with a set of easy to use predefined criteria, without increasing complications and re-admissions.
This study was a prospective cohort study. Patient selection criteria were: <85 years old, ASA 1, 2, and mild ASA 3. Primary outcome variables were successful SDD, complications, re-admissions and patient satisfaction. Secondary outcomes were patient-reported outcome scores. The results are compared with the inpatient cohort.
In total, 163 patients were treated for elective shoulder arthroplasty. Of which 51 patients were selected for same-day discharge arthroplasty. 94% of pre-planned same-day discharge arthroplasty patients were discharged on the day of surgery. In the same-day discharge group, there were no complications related to the early discharge and a 2% readmission rate as opposed to a 3% readmission rate in the inpatient group. Surgery related as well as medical complications did not differ between the same-day discharge and inpatient cohort.
Same-day discharge shoulder arthroplasty is a safe and satisfying treatment option in selected patient groups.
肩关节置换术大多作为住院手术进行。当日出院的关节置换术在髋关节和膝关节手术中已显示出积极效果。本研究的主要目的是调查是否可以通过一套易于使用的预定义标准来预测安全且令人满意的当日出院,同时不增加并发症和再入院率。
本研究为前瞻性队列研究。患者选择标准为:年龄<85岁,美国麻醉医师协会(ASA)分级为1、2级以及轻度3级。主要结局变量为成功的当日出院、并发症、再入院和患者满意度。次要结局为患者报告的结局评分。将结果与住院队列进行比较。
总共163例患者接受了择期肩关节置换术治疗。其中51例患者被选作当日出院的关节置换术。94%计划当日出院的关节置换术患者在手术当天出院。在当日出院组中,没有与早期出院相关的并发症,再入院率为2%,而住院组的再入院率为3%。当日出院组和住院队列之间的手术相关及医疗并发症无差异。
对于选定的患者群体,当日出院的肩关节置换术是一种安全且令人满意的治疗选择。