Patient Perceptions of Same-Day Discharge Versus Overnight Stay After Total Joint Arthroplasty: Results of a Survey

Daniel F. O’Brien, Thomas C. Sullivan, Bradley S. Lambert, Timothy S. Brown, S. Incavo, Kwan J. Park
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Abstract

In the COVID-19 era, there has been increasing interest in same-day discharge (SDD) after total joint arthroplasty (TJA). However, patient perception of SDD is not well reported. We sought to understand patients’ perceptions and preferences of postoperative care by surveying patients who have completed both an overnight stay (ONS) and an SDD after TJA. We emailed survey links to 67 patients who previously underwent either 2 total hip arthroplasties (THAs) or 2 total knee arthroplasties (TKAs). Fifty-two patients (78%) responded to the survey. Thirty-four (65%) patients underwent staged, bilateral TKAs, and 18 (35%) patients underwent staged, bilateral THAs. Overall, 63% of patients preferred their SDD, 12% had no preference, and 25% preferred their ONS, with no difference in preference between TKA and THA groups. Those who preferred their SDD reported being more comfortable at home. Those who preferred their ONS felt their pain and concerns were better addressed. No differences were found in comfort, sleep quality, appetite, burden on family, return to function, feelings of being discharged too soon, overall experience, 30-day emergency department (ED) visits, or readmissions within 30 days between patients’ SDD and ONS. There was a small statistically significant difference between patients’ perception of safety between SDD and ONS. Our survey found that most patients reported a preference for SDD after TJA over ONS. Although there was a small difference in patient perception of safety, there were no differences in return to the ED or readmissions after SDD and ONS.
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患者对全关节置换术后当天出院与过夜住院的看法:调查结果
在 COVID-19 时代,人们对全关节置换术(TJA)后当天出院(SDD)越来越感兴趣。然而,患者对 SDD 的看法却鲜有报道。我们试图通过对 TJA 术后完成过夜住院(ONS)和 SDD 的患者进行调查,了解患者对术后护理的看法和偏好。我们通过电子邮件向 67 名曾接受过 2 次全髋关节置换术 (THAs) 或 2 次全膝关节置换术 (TKAs) 的患者发送了调查链接。52名患者(78%)回复了调查。34名患者(65%)接受了分期双侧TKA,18名患者(35%)接受了分期双侧THA。总体而言,63%的患者倾向于接受 SDD,12%的患者没有偏好,25%的患者倾向于接受 ONS,TKA 组和 THA 组患者的偏好没有差异。首选 SDD 的患者表示在家中更舒适。喜欢 ONS 的人认为他们的疼痛和担忧得到了更好的解决。SDD组和ONS组患者在舒适度、睡眠质量、食欲、家庭负担、功能恢复、过早出院的感觉、总体体验、30天急诊室就诊率或30天内再入院率方面没有差异。在统计意义上,SDD 和 ONS 患者对安全的感知存在微小差异。我们的调查发现,与 ONS 相比,大多数患者在 TJA 术后更倾向于 SDD。虽然患者对安全性的感知存在微小差异,但 SDD 和 ONS 后在返回急诊室或再入院方面没有差异。
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