Adapting hip arthroplasty practices during the COVID-19 pandemic: Assessing the impact of outpatient care sudden increase on early complications and clinical outcomes.

IF 1.8 Q2 ORTHOPEDICS SICOT-J Pub Date : 2024-01-01 Epub Date: 2024-01-09 DOI:10.1051/sicotj/2023037

Constant Foissey, Tomas Pineda, Elvire Servien, Andreas Fontalis, Cécile Batailler, Sébastien Lustig

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Abstract

Introduction: The COVID-19 pandemic has significantly affected access to timely care for patients with hip osteoarthritis requiring total hip replacement (THR). This study aimed to assess the changes in surgical activity, outpatient treatment, length of stay (LOS), discharge destinations, readmission rates, clinical outcomes, and patient satisfaction before and after the pandemic at our institution.

Materials and methods: This retrospective study encompassed patients undergoing primary THR through the direct anterior approach at a single university hospital. Data on demographic characteristics, surgical technique, perioperative management, LOS, discharge destinations, complications, and clinical outcomes were collected. Furthermore, a comparative analysis between the pre-pandemic (2019) and post-pandemic (2022) periods was conducted.

Results: There was a 14% increase in surgical activity post-pandemic, with 214 patients undergoing surgery in 2019 versus 284 in 2022. The percentage of patients managed as outpatients significantly increased from 0.5% in 2019 to 29.6% in 2022 (p < 0.001). LOS decreased from 2.7 ± 1 [0-8] days to 1.4 ± 1.1 [0-12] days (p < 0.001), and the rate of discharge to rehabilitation centres declined from 21.5% to 8.8% (p < 0.001). No significant increase in the readmission rates was observed (1.4% in both periods). At two months postoperatively, the mean HHS and satisfaction rates were comparable between the two groups (p = 1 and p = 0.73, respectively).

Discussion: Despite the challenges posed by the COVID-19 pandemic, surgical activity at our institution demonstrated an increase compared to the pre-pandemic levels by expanding outpatient care, reducing LOS, and increasing rates of home discharges. Importantly, these changes did not adversely affect rehospitalization rates or early clinical outcomes.

Level of evidence: IV.

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在COVID-19大流行期间调整髋关节置换术实践：评估门诊护理突然增加对早期并发症和临床结果的影响。

导言：COVID-19 大流行严重影响了需要进行全髋关节置换术 (THR) 的髋关节骨关节炎患者及时获得治疗的机会。本研究旨在评估大流行前后我院在手术活动、门诊治疗、住院时间（LOS）、出院目的地、再入院率、临床结果和患者满意度方面的变化：这项回顾性研究涵盖了在一家大学医院通过直接前路方法进行初次全脊椎十字路口置换术的患者。研究收集了人口统计学特征、手术技术、围手术期管理、住院时间、出院去向、并发症和临床结果等方面的数据。此外，还对大流行前（2019 年）和大流行后（2022 年）进行了对比分析：结果：大流行后的手术活动增加了 14%，2019 年有 214 名患者接受了手术，而 2022 年则有 284 名。门诊病人的比例从 2019 年的 0.5%大幅增至 2022 年的 29.6%（P 讨论）：尽管 COVID-19 大流行带来了挑战，但与大流行前的水平相比，我院的手术活动有所增长，扩大了门诊治疗范围，缩短了住院时间，提高了家庭出院率。重要的是，这些变化并未对再住院率或早期临床结果产生不利影响：证据等级：IV。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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