Joint arthroplasty Perioperative Surgical Home:Impact of patient characteristics on postoperative outcomes

作     者：Duy L Phan Kyle Ahn Joseph B Rinehart Michael-David Calderon Wei-Der Wu Ran Schwarzkopf 

作者机构：Department of Orthopaedic Surgery Universityof California Irvine Medical Center Department of Anesthesiology University of CaliforniaIrvine Medical Center Division of Adult Reconstruction Departmentof Orthopaedic Surgery New York University Langone Medical Center 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2016年第7卷第6期

页      面：376-382页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Perioperative Surgical Home Arthroplasty Length of stay American Society of Anesthesiologists Physical Classification System Body mass index 

摘      要：AIM:To determine the impact of different characteristics on postoperative outcomes for patients in a joint arthroplasty Perioperative Surgical Home(PSH) ***:A retrospective review was performed for patients enrolled in a joint arthroplasty PSH program who had undergone primary total hip arthroplasty(THA) and total knee arthroplasty(TKA).Patients were preoperatively stratified based on specific procedure performed,age,gender,body mass index(BMI),American Society of Anesthesiologists Physical Classification System(ASA) score,and Charleston Comorbidity Index(CCI) *** primary outcome criterion was hospital length of stay(LOS).Secondary criteria including operative room(OR) duration,trans-fusion rate,Post-Anesthesia Care Unit(PACU) stay,readmission rate,post-operative complications,and discharge *** each outcome,the predictor variables were entered into a generalized linear model with appropriate response and assessed for predictive relationship to the dependent *** level was set to ***:A total of 337 patients,200 in the TKA cohort and 137 in the THA cohort,were eligible for the *** two-third of patients were *** age averaged 64 years and preoperative BMI averaged 29 kg/*** majority of patients were ASA score Ⅲ and CCI score *** analysis,ASA score was the only variable predictive for LOS(P = 0.0011) and each increase in ASA score above 2 increased LOS by approximately 0.5 *** score was also the only variable predictive for readmission rate(P = 0.0332).BMI was the only variable predictive for PACU duration(P = 0.0136).Specific procedure performed,age,gender,and CCI score were not predictive for any of the outcome *** duration,transfusion rate,postoperative complications or discharge disposition were not significantly associated with any of the predictor ***:The joint arthroplasty PSH model reduces postoperative outcome variability for patients with different preo