Patient Satisfaction and Risk of Falls with the Use of Intermittent Pneumatic Compression Devices Following Total Joint Arthroplasty.

Abstract

Introduction: Patients who undergo total joint arthroplasty (TJA) are at a high risk for the development of thromboembolic complications. The rate at which venous thromboembolism occurs following TJA has been reported to be between 0.5% to 1.0%. As a result, the utilization of prophylactic therapies is considered the standard of care in this patient population. The primary purpose of the current study was to 1. evaluate patient satisfaction with the home use of intermittent pneumatic compression (IPC) devices following TJA and 2. evaluate the risk of self-reported falls secondary to the use of these devices following TJA.

Methods: This is a single institution, prospective study on patients who underwent TJA at an urban, academic orthopedic specialty hospital. Utilizing an electronic patient rehabilitation application (EPRA) that wirelessly pushes digital surveys at predefined time intervals, patients were surveyed regarding their use and satisfaction with their home IPC devices. They were also asked if they experienced any falls or near-falls. Surveys were administered on postoperative day 14, and patients were given 10 days to submit their responses. Using our institutions data warehouse, patient demographics including age, sex, surgery, laterality, insurance type, and length of stay were collected.

Results: Survey responses were collected from 424 patients who underwent TJA between August 2018 and January 2019. Of the respondents, 248 were female and 176 were male. Approximately 79% of patients in the cohort were satisfied with their use of their compression devices compared to 21% of patients who were unsatisfied. During this time, 19.3% (82 patients) also reported at least one tripping episode at home while using the device, while 80.7% (342 patients) never had a tripping incident at home. Finally, 1.4% (six patients) had at least one fall at home, while 98.6% (418 patients) did not have any falls at home.

Conclusion: These results suggest that our patients were significantly dissatisfied with their home intermittent compression devices. There are a significant number of trips or falls following TJA and further study is needed examining the potential causality of these devices and their cords in these falls.