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Pre-Operative Predictors for Discharge to Post-Acute Care Facilities After Total Knee Arthroplasty.
Zeng, Chan; Koonce, Ryan C; Tavel, Heather M; Argosino, Suzanne E; Kiepe, Denise A; Lyons, Ella E; Ford, Morgan A; Steiner, Claudia A.
Afiliação
  • Zeng C; Kaiser Permanente Colorado, Institute for Health Research, Aurora, CO.
  • Koonce RC; Department of Orthopedic Surgery, University of Colorado School of Medicine, Highlands Ranch, CO.
  • Tavel HM; Kaiser Permanente Colorado, Institute for Health Research, Aurora, CO.
  • Argosino SE; Kaiser Permanente Colorado, Orthopedics Department, Denver, CO.
  • Kiepe DA; Kaiser Permanente Colorado, Orthopedics Department, Denver, CO.
  • Lyons EE; Kaiser Permanente Colorado, Institute for Health Research, Aurora, CO.
  • Ford MA; Kaiser Permanente Colorado, Institute for Health Research, Aurora, CO.
  • Steiner CA; Kaiser Permanente Colorado, Institute for Health Research, Aurora, CO; Colorado Permanente Medical Group, Denver, CO.
J Arthroplasty ; 37(1): 31-38.e2, 2022 01.
Article em En | MEDLINE | ID: mdl-34619305
BACKGROUND: Joint replacement surgery is in increasing demand and is the most common inpatient surgery for Medicare beneficiaries. The venue for post-operative rehabilitation, including early outpatient therapy after surgery, influences recovery and quality of life. As part of a comprehensive total joint program at Kaiser Permanente Colorado, we developed and validated a predictive model to anticipate and plan the disposition for rehabilitation of our patients after total knee arthroplasty (TKA). METHODS: We analyzed data for TKA patients who completed a pre-operative Total Knee Risk Assessment in 2017 (the model development cohort) or during the first 6 months of 2018 (the model validation cohort). The Total Knee Risk Assessment, which is used to guide disposition for rehabilitation, included questions in mobility, social, and environment domains. Multivariable logistic regression was used to predict discharge to post-acute care facilities (PACFs) (ie, skilled nursing facilities or acute rehabilitation centers). RESULTS: Data for a total of 1481 and 631 patients who underwent TKA were analyzed in the development and validation cohorts, respectively. Ninety-three patients (6.3%) in the development cohort and 22 patients (3.5%) in the validation cohort were discharged to PACFs. Eight risk factors for discharge to PACFs were included in the final multivariable model. Patients with a diagnosis of neurological disorder and with a mobility/balance issue had the greatest chance of discharge to PACFs. CONCLUSION: This validated predictive model for discharge disposition following TKA may be used as a tool in shared decision-making and discharge planning for patients undergoing TKA.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia de Quadril / Artroplastia do Joelho Tipo de estudo: Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Aged / Humans País/Região como assunto: America do norte Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia de Quadril / Artroplastia do Joelho Tipo de estudo: Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Aged / Humans País/Região como assunto: America do norte Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos