A new study published in the Journal of Arthroplasty examines total knee replacements in the outpatient setting for the Medicare population.
Study authors examined the ACS-NSQIP database for patients age 65 and older who underwent total knee replacements from 2014 to 2015, including 49,136 Medicare-aged patients. Around 0.7 percent of the patients were outpatient while another 6 percent were short stay; the remaining 93 percent of patients had inpatient procedures.
Study authors found:
1. The patients who underwent short-stay procedures reported fewer complications than the outpatient and inpatient groups; 2 percent of the short-stay group had complications, compared with 8 percent of the inpatient and outpatient procedures.
2. The independent risk factors for complications included:
- Inpatient stays for female patients
- General anesthesia
- Diabetes mellitus
- Chronic obstructive pulmonary disease
- Hypertension
- Kidney disease
- BMI over 35
- Age older than 75 years old
3. Study authors concluded total knee replacements for the Medicare population can be performed safely in the outpatient setting.
4. The 23-hour stay setting could be the "sweet spot" for the Medicare population, according to the study authors.
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