Evidence map›Paper›PMID 23412186›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2013

Modifiable factors delaying early discharge following primary joint arthroplasty.

R J Napier, D Spence, O Diamond, S O'Brien, T Walsh, D E Beverland

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03690037 (Single Centre Randomised Controlled Trial to Assess the Effect of the Addition of Twenty-four Hours of Oral Tranexamic Acid Post-operatively to a Single Intra-operative Intravenous Dose of Tranexamic Acid on Calculated Blood Loss Following Primary Hip and Knee Arthroplasty.), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03690037 phase4completednot on this mapstarted 2016, after this paper: background citation

Single Centre Randomised Controlled Trial to Assess the Effect of the Addition of Twenty-four Hours of Oral Tranexamic Acid Post-operatively to a Single Intra-operative Intravenous Dose of Tranexamic Acid on Calculated Blood Loss Following Primary Hip and Knee Arthroplasty.

TypeinterventionalSponsorBelfast Health and Social Care TrustRan2016 to 2019Enrolled1,089ConditionsPrimary Total Knee Arthroplasty, Primary Total Hip ArthroplastyArmsTranexamic Acid 100 MG/ML, Tranexamic Acid 500 MG
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Modifiable factors influencing length of stay after total knee arthroplasty.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023
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  15. Fast track in hip arthroplasty.EFORT open reviews · 2017
    Article
  16. Factors influencing length of hospital stay after primary total knee arthroplasty in a fast-track setting.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016
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  17. Article
  18. Article
  19. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

R J NapierOutcomes Assessment Unit, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB, Northern Ireland, UK. rjnapier@doctors.org.uk
D Spence
O Diamond
S O'Brien
T Walsh
D E Beverland

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsRecent NHS reforms have incentivised reduction in length of stay, with the UK department of health expecting health trusts to reduce bed days and ultimately reduce overall costs. The aim of this study was to identify avoidable causes for protracted hospital admission following total hip arthroplasty (THA) or total knee arthroplasty (TKA) within a fast-track unit.

methodsDuring a 6-month period, 535 consecutive patients underwent primary THA or TKA under the care of a single surgeon. All patients with a post-operative stay of greater than 72 h were identified, and reasons for delayed discharge were determined.

resultsThe majority of arthroplasty patients were discharged within 3 days post-operatively. Twenty-one per cent of THA patients and 25 % of TKA patients remained as inpatients for greater than 72 h. For the THA population, this equates to 43 % of bed days used by 21 % of patients, and for the TKA population, 44 % of bed days were used by 25 % of patients. The major factor within both groups for delayed discharge was attributed to inadequate social support.

conclusionsDelayed discharge can never be totally prevented. This unit aims to develop improvement in social work provision, with a greater focus on pre-admission discharge planning to reduce the number of delayed discharges and ultimately reduce the cost burden of joint replacement surgery. It is not conducive with the ethos of fast-track arthroplasty to only identify social circumstances upon admission.

Indexed as

AgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeCost of IllnessFemaleHealth Services ResearchHumansLength of StayMaleMiddle AgedPatient DischargeRegression AnalysisTreatment Outcome

Identifiers

PMID23412186

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.