Background

This study aimed to investigate factors affecting discharge to an inpatient rehabilitation facility or home following total hip arthroplasty, using a clinical pathway in Japan.

Methods

Five hundred hips with osteoarthritis who underwent unilateral total hip arthroplasty at our institution, with no deviation from the pathway, were included in this retrospective study. The variables were examined by univariate analysis. Multivariate logistic regression analysis was used to identify the independent factors that influenced the discharge outcome.

Results

Four hundred and thirty-four hips were discharged home directly, and 66 were discharged to an inpatient rehabilitation facility. Patients discharged to an inpatient rehabilitation facility were significantly older, shorter, lighter, and more likely to live alone. Additionally, the preoperative clinical score was significantly lower in the inpatient rehabilitation facility Group for all items. Logistic regression analysis showed a significant association between being discharged to an inpatient rehabilitation facility and higher age [odds ratio 3.87, 95% confidence interval 2.03–7.38, P < 0.001], lower total score in the preoperative Japanese Orthopaedic Association hip score [odds ratio 2.42, 95% confidence interval 1.38–4.23, P = 0.002] and living alone [odds ratio 1.84, 95% confidence interval 1.01–3.35, P = 0.046].

Conclusions

In this study, age, the preoperative Japanese Orthopaedic Association hip score, and living arrangement impacted the discharge destination after THA.

中文翻译：

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全髋关节置换术后出院目的地的预测因素

背景

本研究旨在利用日本的临床路径，调查影响全髋关节置换术后出院至住院康复机构或家庭的因素。

方法

本回顾性研究纳入了500 名患有骨关节炎的髋关节患者，他们在我们机构接受了单侧全髋关节置换术，没有偏离路径。通过单变量分析检查变量。使用多变量逻辑回归分析来确定影响出院结果的独立因素。

结果

434 例髋关节直接出院回家，66 例髋关节出院到住院康复机构。出院到住院康复机构的患者年龄明显更大、个子更矮、体重更轻，并且更有可能独自生活。此外，住院康复机构组的所有项目的术前临床评分均显着较低。Logistic 回归分析显示，出院到住院康复机构与较高年龄 [比值比 3.87，95% 置信区间 2.03–7.38，P  < 0.001]、术前日本骨科协会髋关节评分较低 [比值比] 之间存在显着相关性。 2.42，95% 置信区间 1.38–4.23，P = 0.002] 和独居 [优势比 1.84，95% 置信区间 1.01–3.35，P = 0.046]。

结论

在这项研究中，年龄、术前日本骨科协会髋关节评分和居住安排影响全髋关节置换术后的出院目的地。