5 years ago

Is rapid recovery hip and knee replacement possible and safe in the octogenarian patient?

Rapid recovery programs are now aimed to reduce costs of hip and knee arthroplasty by discharging patients directly home, shortening hospital length of stay, and reducing readmission rates. While patients 80 years of age and older are included in the Medicare bundle, little work has been done to determine if older patients can safely participate in rapid recovery programs. Methods We retrospectively reviewed 2482 patients undergoing primary and revision THA and TKA who all participated in a multifaceted rapid recovery program. The goals of this program were next day discharge to home without the use of home services or post-acute care admission. We examined the hospital length of stay and the % of patients discharged home as well as 90 day readmission rates to determine efficacy and safety of this program in the patients 80 years of age and older. Results Octogenarians receiving primary THA and TKA were discharged home >90% of the time with length of stays < 2 days and low readmission rates. Revision THA and TKA patients 80 years of age and older were discharged home about 70% of the time with significantly longerlengths of stay than patients < 80 years of age. The revision THA patients over 80 years of age had the highest readmission rates. Conclusion Patients over 80 years of age can successfully and safely participate in rapid recovery programs.

Publisher URL: www.sciencedirect.com/science

DOI: S0883540317308689

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