Background and Aims The introduction of fast track recovery pathways has reduced the hospital length of stay (LOS) allowing patients to be discharged quicker 1. Hospital LOS for elective hip and knee replacements has drastically decreased in the last 2 decades 2. Day case arthroplasty was introduced in our hospital in 2018 when the average LOS was down to 2.4 days and about 15% of patients were discharged after 1 night stay. The purpose of this presentation is to share our experience and data with special focus on patient satisfaction and safety.
Methods 340 patients (ASA 1–2) were selected for day case hip or knee arthroplasty (126 THR,164 TKR; 50 UKR). Same day discharge (SDD), readmission, complication and satisfaction rates were recorded. Short acting opiate free spinal anaesthesia was administered. Hunter’s was performed for TKR and UKR (3). Tranexamic acid and LIA were administered. Planned day cases were scheduled as first and second on the list.
Results 296 patients had SDD while 44 needed overnight stay. Failure to discharge were lack of confidence, fainting, urine retention and late resolution of spinal anaesthesia.7 patients were readmitted within 6 weeks including 1 with a partial pulmonary embolism. 98% of the patient with SDD were satisfied. The average LOS was reduced from 2.4 to 1.8 days and day one discharge increased from 12% to about 60%.
Conclusions In hospitals where the inpatient LOS is already low, day case arthroplasty can be safely introduced without producing increased readmission rates or decreased patient satisfaction.
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