Research published in The Journal of Arthroplasty found performing an Outpatient Arthroplasty Risk Assessment helps identify which patients are appropriate for outpatient total joint arthroplasty.
Researchers reviewed 1,120 patients who had undergone consecutive primary total joint arthroplasties in an early discharge program. An Outpatient Arthroplasty Risk Assessment score was used to score patients as "low-moderate risk" and "not appropriate" for early discharge. The Outpatient Arthroplasty Risk Assessment was developed by a high-volume arthroplasty surgeon and internal medicine specialist. American Society of Anesthesiologists Physical Status Classification System and Charlson comorbidity index were examined in relation to length of stay.
Here are the key research insights to know:
1. The positive predictive score for the Outpatient Arthroplasty Risk Assessment was 81.6 percent for next or same day discharge, compared to 56.4 percent for the American Society of Anesthesiologists Physical Status Classification System and 70.3 percent for the Charlson comorbidity index.
2. Patients with Outpatient Arthroplasty Risk Assessment scores lesser than or equal to 59 were twice as likely to be discharged earlier than those with scores greater than or equal to 60.
3. A patient with a low American Society of Anesthesiologists Physical Status Classification System score was 1.7 times more likely to be discharged early, while the Charlson comorbidity index did not predict early discharge.
4. "The OARA score for primary TJA has more precise predictive ability than the ASA-PS and CCI scores for the same or next day discharge and is enhanced with a robust patient education program to establish appropriate expectations for early discharge," the researchers concluded. "Early results suggest that the OARA score can successfully facilitate appropriate patient selection for outpatient TJA, although consideration of clinical program maturity before adoption of the score is advised."
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