Hirsi Abdullahi Abdirisak, Danielsen Oddrún, Varnum Claus, Jakobsen Thomas, Andersen Mikkel Rathsach, Bieder Manuel Josef, Overgaard Søren, Jørgensen Christoffer Calov, Kehlet Henrik, Gromov Kirill, Lindberg-Larsen Martin
Center for Fast-track Hip and Knee Replacement, Copenhagen; Department of Orthopaedic Surgery and Traumatology, Odense University Hospital and Svendborg, Denmark.
Center for Fast-track Hip and Knee Replacement, Copenhagen; Department of Orthopaedic Surgery, Lillebaelt Hospital - Vejle, Denmark.
Acta Orthop. 2025 Mar 13;96:265-271. doi: 10.2340/17453674.2025.43001.
Discharge on day of surgery after hip or knee arthroplasty is increasing, but whether this leads to an increase in the overall number of post-discharge healthcare system contacts is unknown. We aimed to investigate whether day-case surgery leads to increased patient-reported healthcare system contacts compared with non-day-case surgery within the first 30 days postoperatively.
We performed a prospective multicenter study at seven fast-track centers from September 2022 to August 2023. Candidates for primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or unicompartmental knee arthroplasty (UKA) were evaluated for day-case eligibility using pre-defined criteria. Patients received a survey 30 days postoperatively regarding any healthcare system contacts related to surgery. Planned healthcare visits were excluded. We used day-case eligible patients not discharged on day of surgery (inpatients) as control group.
Of 2,278 day-case eligible patients, 2,073 (91%) completed the survey, including 1,146 day-case patients (55%) and 927 inpatients (45%). The overall rate of healthcare system contacts was 49% (95% confidence interval [CI] 45-51) in day-case patients compared with 52% (CI 49-56) in inpatients. Specific contacts included visits to a general practitioner (GP) or out-of-hours medical clinic (25% [CI 22-27] vs 32% [CI 29-35]), the emergency department (ED) (6% [CI 4-7] vs 7% [CI 5-8]), and outpatient clinics or wards (35% [CI 33-38] vs 35% [CI 32-38]). The most common reasons for all types of healthcare contacts were wound problems, prescription renewals, and pain management.
Day-case hip and knee arthroplasties was not associated with increased healthcare system contacts within the first 30 days postoperatively.
髋关节或膝关节置换术后在手术当天出院的情况日益增多，但这是否会导致出院后医疗保健系统接触的总数增加尚不清楚。我们旨在调查与非日间手术相比，日间手术是否会导致患者报告的术后30天内医疗保健系统接触增加。
2022年9月至2023年8月，我们在7个快速通道中心进行了一项前瞻性多中心研究。使用预先定义的标准评估初次全髋关节置换术（THA）、全膝关节置换术（TKA）或单髁膝关节置换术（UKA）的患者是否适合日间手术。患者在术后30天接受了一项关于与手术相关的任何医疗保健系统接触情况的调查。计划中的医疗就诊被排除在外。我们将符合日间手术条件但未在手术当天出院的患者（住院患者）作为对照组。
在2278名符合日间手术条件的患者中，2073名（91%）完成了调查，其中包括1146名日间手术患者（55%）和927名住院患者（45%）。日间手术患者的医疗保健系统接触总发生率为49%（95%置信区间[CI]45 - 51），而住院患者为52%（CI 49 - 56）。具体接触包括就诊于全科医生（GP）或非工作时间医疗诊所（25%[CI 22 - 27]对32%[CI 29 - 35]）、急诊科（ED）（6%[CI 4 - 7]对7%[CI 5 - 8]）以及门诊诊所或病房（35%[CI 33 - 38]对35%[CI 32 - 38]）。所有类型医疗保健接触的最常见原因是伤口问题、处方续签和疼痛管理。
日间髋关节和膝关节置换术与术后30天内医疗保健系统接触增加无关。
