Given the trend toward value-based care, there has been increased interest in minimizing hospital length of stay (LOS) after orthopedic procedures. Outpatient total ankle arthroplasty (TAA) has become more popular in recent years; however, research on surgical outcomes of this procedure has been limited. This study sought to employ large sample, propensity score-matched analyses to assess the safety of outpatient and short-stay discharge pathways following TAA. The ACS NSQIP database was used to identify 1141 patients who underwent primary and revision TAA between 2007 and 2017. Propensity score matching was used to match patients based on several factors, including age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, and several comorbidities. The incidence of various 30-day complications was compared between the short and standard LOS groups to assess for any differences in short-term outcomes. A total of 892 patients were included in the final propensity score-matched analysis, with 446 patients in each group. The short LOS group had a significantly lower rate of medical complications (0.2% vs. 2.5%, p = 0.006) and non-home discharge (1.3% vs. 12.1%, p < 0.001). There was no significant difference in operative complications (0.4% vs. 1.8%, p = 0.107), unplanned readmission (0.4% vs. 1.1%, p = 0.451), reoperation (0.2% vs. 0.4%, p > 0.999), return to the OR (0.2% vs. 0.9%, p = 0.374), or mortality (0.7% vs. 0.0%, p > 0.249) between the short and standard LOS groups. Outpatient and short-stay hospitalization had comparable safety to standard inpatient hospitalization after TAA. Outpatient or short-stay TAA should be considered for patients with low risk of short-term complications.

中文翻译：

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倾向评分匹配分析比较了全踝关节置换术后的门诊和短期住院与标准住院患者的住院率。

考虑到以价值为基础的护理的趋势，人们越来越希望将骨科手术后的住院时间（LOS）降至最低。近年来，门诊全踝关节置换术（TAA）变得越来越流行。然而，对该手术的手术结果的研究是有限的。本研究试图采用大样本，倾向评分匹配的分析来评估TAA后门诊和短期出院路径的安全性。ACS NSQIP数据库用于识别2007年至2017年间接受过原发性和修订版TAA的1141例患者。倾向得分匹配用于根据年龄，性别，体重指数（BMI），美国麻醉医师学会等多种因素对患者进行匹配（ASA）分类和几种合并症。比较短期和标准LOS组之间各种30天并发症的发生率，以评估短期结局是否存在差异。共有892例患者被纳入最终倾向评分匹配分析，每组446例患者。短期LOS组的医疗并发症发生率（0.2％vs. 2.5％，p = 0.006）和非家庭出院率（1.3％vs. 12.1％，p <0.001）显着降低。手术并发症（0.4％vs. 1.8％，p = 0.107），计划外再次入院（0.4％vs. 1.1％，p = 0.451），再次手术（0.2％vs. 0.4％，p> 0.999）无显着差异，短期和标准LOS组之间的OR（0.2％vs. 0.9％，p = 0.374）或死亡率（0.7％vs. 0.0％，p> 0.249）。TAA后，门诊和短期住院的安全性与标准住院患者相当。