Half of all hip and knee arthroplasty patients may be potential day-case candidates: a nationwide register study of 166,730 procedures
DOI:
https://doi.org/10.2340/17453674.2024.40075Keywords:
Arthroplasty, Day-case surgery, Hip, Knee, Same day dischargeAbstract
Background and purpose: The overall potential pool of day-case candidates on a national level in hip and knee arthroplasty is unknown. We aimed to estimate the proportion of hip and knee arthroplasty patients eligible for day-case surgery based on contemporary widely used criteria and determine whether there has been a change in the proportion of eligible patients over time and, secondarily, to investigate the proportion of eligible patients discharged on the day of surgery.
Methods: Based on data from the Danish National Patient Register, we identified all patients undergoing primary unilateral hip or knee arthroplasty from January 2010 to March 2020. Using a modification of day-case eligibility criteria proposed by a national multicenter collaboration, we sorted patients into either day-case eligible or ineligible. A day-case procedure was defined as discharge on the day of surgery.
Results: We included patients comprising a total of 166,730 primary total hip (THA), total knee (TKA), and unicompartmental knee arthroplasty (UKA). 48% (95% confidence interval [CI] 48–49) were eligible for day-case surgery, with a decline from 50% (CI 49–51) in 2010 to 46% (CI 46–47) eligible in 2019. More UKA patients were day-case eligible (55%, CI 54–56) than THA (47%, CI 47–48) and TKA patients (49%, CI 48–49). A maximum of 8.0% (CI 7.4–8.5) of eligible patients were discharged on the day of surgery in 2019.
Conclusion: 48% of the Danish hip and knee arthroplasty patients were potential day-case candidates, with a small decline in eligibility from 50% in 2010 to 46% in 2019. Day of surgery discharge among day-case eligible patients peaked at 8% in 2019. Thus, the potential for more day-case surgery seems large.
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Copyright (c) 2024 Christian Bredgaard Jensen, Anders Troelsen, Nicolai Bang Foss, Christian Skovgaard Nielsen, Martin Lindberg-Larsen, Kirill Gromov
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