Safety and outcomes of outpatient compared to inpatient total knee arthroplasty: a national retrospective cohort study
Safety and outcomes of outpatient compared to inpatient total knee arthroplasty: a national retrospective cohort study
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DOI：
10.1136/rapm-2020-101686
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发表时间：
2021-01-01
影响因子：
5.1
通讯作者：
De Oliveira, Gildasio S.
中科院分区：
文献类型：
--
作者：
Mai, Harry T.;Mukhdomi, Taif;De Oliveira, Gildasio S.
许多因素促使全膝关节置换术更常在门诊患者中进行（48小时、计划外插管、脓毒症/脓毒性休克和死亡）。倾向匹配分析用于调整潜在的混杂协变量。结果1099例门诊全膝关节置换术患者（占总病例的1%）与1099例住院手术患者成功匹配。门诊手术中严重不良事件的复合发生率高于住院手术（3.18% vs 1.36%，p=0.005）。相比之下，两组之间的抢救失败率和再入院率没有差异。结论门诊全膝关节置换术与住院手术相比，严重不良事件的综合风险更高。麻醉师和外科医生应告知患者，并在获得手术同意和计划出院时间时讨论此信息。
Background Many factors are driving total knee arthroplasty to be performed more commonly as an outpatient (48 hours, unplanned intubation, sepsis/septic shock, and death. Propensity matched analysis was used to adjust for potential confounding covariates.Results 1099 patients undergoing outpatient total knee arthroplasty (1% of total cases) were successfully matched to 1099 patients undergoing inpatient surgeries. The composite rate of serious adverse events was greater in outpatient procedures compared with inpatient procedures (3.18% vs 1.36%, p=0.005). In contrast, failure to rescue and readmission rates were not different between groups.Conclusions Outpatient total knee arthroplasty is associated with a higher composite risk of serious adverse events than inpatient procedures. Anesthesiologists and surgeons should inform patients and discuss this information when obtaining consent for surgery and planning for discharge timing.