Predicting discharge outcome after elective hip and knee arthroplasty

M. C. Munin, Chian K Kwoh, N. Glynn, L. Crossett, H. E. Rubash

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

The objective of this prospective study was to determine if differences exist between individuals who require an inpatient rehabilitation program after elective hip and knee arthroplasty from those patients who can be discharged directly home. Multiple variables consisting of baseline demographics, social status, insurance status, medical history, pain level, quantitative strength, range of motion, and functional ability were examined. The primary outcome measure was the discharge destination from the orthopedic service and consisted of either a discharge to home or a discharge to an inpatient rehabilitation unit. Of the 162 patients followed, 65 (40%) were discharged to an inpatient rehabilitation unit, whereas 97 were discharged to home. The patients discharged to inpatient rehabilitation tended to live alone, were significantly older (mean difference = 6.3 yr), and had increased comorbid conditions (P < 0.001 for all variables). Patients discharged to a rehabilitation unit reported significantly greater pain levels than those discharged to home (P < 0.001). The attainment of a supervision level of function demonstrated greater differences between groups than the attainment of independent function for all functional measures. A logistic regression model was developed that predicted 76% of the discharges to rehabilitation by the third physical therapy session postsurgery. In conclusion, predictive markers do exist that differentiate individuals who require further inpatient therapy services after joint replacement surgery.

Original languageEnglish (US)
Pages (from-to)294-301
Number of pages8
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume74
Issue number4
StatePublished - 1995
Externally publishedYes

Fingerprint

Knee Replacement Arthroplasties
Hip
Rehabilitation
Inpatients
Replacement Arthroplasties
Logistic Models
Pain
Aptitude
Insurance Coverage
Social Security
Articular Range of Motion
Orthopedics
Demography
Outcome Assessment (Health Care)
Prospective Studies
Therapeutics

Keywords

  • Hip Arthroplasty
  • Knee Arthroplasty
  • Outcome
  • Rehabilitation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Rehabilitation
  • Health Professions(all)
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Predicting discharge outcome after elective hip and knee arthroplasty. / Munin, M. C.; Kwoh, Chian K; Glynn, N.; Crossett, L.; Rubash, H. E.

In: American Journal of Physical Medicine and Rehabilitation, Vol. 74, No. 4, 1995, p. 294-301.

Research output: Contribution to journalArticle

Munin, M. C. ; Kwoh, Chian K ; Glynn, N. ; Crossett, L. ; Rubash, H. E. / Predicting discharge outcome after elective hip and knee arthroplasty. In: American Journal of Physical Medicine and Rehabilitation. 1995 ; Vol. 74, No. 4. pp. 294-301.
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