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EP011 Same-day hip arthroplasty: an analysis of factors impeding discharge
  1. William Aerts1,
  2. Thomas Hermans2,
  3. Ana Lopez2,3,
  4. Catherine Vandepitte2,3,
  5. Leander Mancel2,
  6. Walter Staelens2,
  7. Kristoff Corten4 and
  8. Imré Van Herreweghe2,3
  1. 1Genk, Belgium
  2. 2Anesthesiology, Ziekenhuis Oost-Limburg, Genk, Belgium
  3. 3New York School of Regional Anesthesia (NYSORA), New York, USA
  4. 4Orthopedics, Ziekenhuis Oost-Limburg, Genk, Belgium

Abstract

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Background and Aims Same-day hip arthroplasty (SDHA) is becoming increasingly popular due to its association with quicker rehabilitation and enhanced patient satisfaction. However, standard guidelines for discharging patients after SDHA are lacking. Reported discharge rates range between 88% to 95%, and readmission rates vary between 0.03 to 4.6%. This study reports our experience with SDHA at our institution in Genk, Belgium.

Methods We analyzed data from patients scheduled for SDHA over a 14-month period. The perioperative protocol included short-acting spinal anesthesia, pericapsular nerve group block, and a standardized multimodal analgesia regimen. Patient demographics such as age and BMI were collected. Medical records were searched for incidence of complications including nausea, vomiting, urinary retention, hypotension, and vagal responses. Reasons for delays in same-day discharge and rate of readmissions were also assessed.

Results Ninety-three patients underwent the SDHA pathway. The average age was 57 (11) years and the average BMI of 26 (4) kg/m2, while 57% were men. Eighty three percent were discharged on the day of surgery. Factors affecting discharge included orthostatic hypotension and vasovagal reactions (31%), nausea and vomiting, (12%), wound oozing (6%), and/or inadequate analgesia (12%). The average pain score on the first postoperative day was 3,7 (1,8) and there were no readmissions.

Conclusions Discharge rates in our institution align with the existing literature. The most common impediments to timely discharge were orthostatic hypotension and vasovagal reactions. We plan to further investigate predisposing factors and develop strategies to address these obstacles, with the goal of enhancing our discharge rates.

  • Total hip arthroplasty
  • pericapsular nerve group block
  • spinal anesthesia
  • multimodal analgesia.

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