Comparison of outpatient versus inpatient total hip and knee arthroplasty: A systematic review and meta-analysis of complications.
Introduction: Patients undergoing TKA or THA have traditionally been managed post-operatively as inpatients. However, with current surgical techniques and pain management, there is evidence that outpatient joint arthroplasty can be safely performed in selected patient. This systematic review and met...
| Publicado en: | Journal of Orthopaedics Vol. 17; pp. 38 - 44 |
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| Autores principales: | , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Professor PK Surendran Memorial Education Foundation
Jan/Feb2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141678000&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141678000 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 25899082 1CUL jtl: Journal of Orthopaedics issn: 25899082 maglogo: N pubinfo: dt: Jan/Feb2020 vid: 17 pid: 24594 pub: Professor PK Surendran Memorial Education Foundation artinfo: ui: 141678000 141678000 141678000 10.1016/j.jor.2019.08.022 141678000 ppf: 38 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Comparison of outpatient versus inpatient total hip and knee arthroplasty: A systematic review and meta-analysis of complications. aug: au: Xu, Joshua Cao, Jacob Y. Chaggar, Gurpreet S. Negus, Jonathan J. affil: Sydney Medical School, University of Sydney, NSW, Australia sug: subj: Arthroplasty, Replacement, Hip Adverse Effects Arthroplasty, Replacement, Knee Adverse Effects Postoperative Complications Risk Factors Risk Assessment Treatment Outcomes Human Outpatients Inpatients Systematic Review Meta Analysis Body Mass Index Female Male Pneumonia Risk Factors Readmission Evaluation Reoperation Evaluation Health Care Costs Patient Selection Female Male ab: Introduction: Patients undergoing TKA or THA have traditionally been managed post-operatively as inpatients. However, with current surgical techniques and pain management, there is evidence that outpatient joint arthroplasty can be safely performed in selected patient. This systematic review and meta-analysis aimed to compare the post-operative complication rates of outpatient and inpatient TJA with subgroup analysis of TKA and THA. Methods: Electronic searches were performed using five databases from their date of inception to October 2018. Relevant studies were identified, with data extracted and meta-analyzed from the studies. Results: From seven included studies, 176,179 patients were inpatient TJA and 1613 were outpatient TJA. The outpatient and inpatient TJA cohorts had similar mean age and BMI, with a greater proportion of females in the inpatient group. For TJA we found no significant difference in total complications (P=0.06), major complications (P=0.59), readmissions (P=0.60), DVT (P=0.94), UTI (P=0.50), pneumonia (P=0.42) and wound complications (P=0.50) between the outpatient and inpatient groups. However, there were fewer transfusions (P=0.05) but increased reoperations (P=0.02) in the outpatient TJA group. Subgroup analysis of TKA (P=0.25) and THA (P=0.39) also found no significant differences in total complications between the outpatient and inpatient groups. Conclusion: Outpatient TJA had comparable total complication rates to inpatient TJA. Along with that outpatient TJA can significantly reduce costs to healthcare systems but careful pre-operative patient selection is required to optimize outcomes. More quality randomized controlled trials with longer follow-up periods are needed to add to this body of evidence. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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