ArticleClinical interventions in aging2013
Fall-related admissions after fast-track total hip and knee arthroplasty - cause of concern or consequence of success?
Article in Clinical interventions in aging, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03008967 (A Prospective Cohort Study of Patients Undergoing Total Knee and Hip Arthroplasty at a Regional Hospital in Denmark), which is not on this map. Cited by 25 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
A Prospective Cohort Study of Patients Undergoing Total Knee and Hip Arthroplasty at a Regional Hospital in Denmark
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Pooled it
- A systematic review and meta-analysis of fall incidence and risk factors in elderly patients after total joint arthroplasty.Medicine · 2020Pooled it
- Economic analyses of fast-track total hip and knee arthroplasty: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2020Pooled it
- Review
- Preoperative Factors Associated With Falls Following Total Hip Arthroplasty in Older Adults.ACR open rheumatology · 2025Article
- The impact of mental state altering medications on preventable falls after total hip or total knee arthroplasty: a systematic review and meta-analysis.Patient safety in surgery · 2024Review
- Risk factors of post discharge falls in patients undergoing total knee arthroplasty: An integrative review.Journal of back and musculoskeletal rehabilitation · 2024Review
- The Impact of Living Arrangements on the Prevalence of Falls after Total Joint Arthroplasty: A Comparison between Institutionalized and General Geriatric Population.International journal of environmental research and public health · 2023Article
- Key Components, Current Practice and Clinical Outcomes of ERAS Programs in Patients Undergoing Orthopedic Surgery: A Systematic Review.Journal of clinical medicine · 2022Review
- Balance Remains Impaired after Hip Arthroplasty: A Systematic Review and Best Evidence Synthesis.Diagnostics (Basel, Switzerland) · 2022Review
- Fast-Track Programs in Total Hip and Knee Replacement at Swedish Hospitals-Influence on 2-Year Risk of Revision and Mortality.Journal of clinical medicine · 2021Article
- Wearable devices for patient monitoring in the early postoperative period: a literature review.mHealth · 2021Review
- Introducing enhanced recovery after surgery in a high-volume orthopaedic hospital: a health technology assessment.BMC health services research · 2020Observational
- Benefits of direct patient discharge to outpatient physical therapy after total knee arthroplasty.Disability and rehabilitation · 2020Article
- Complications and readmissions following outpatient total hip and knee arthroplasty: a prospective 2-center study with matched controls.Acta orthopaedica · 2019Article
- Fast-tracking for total knee replacement reduces use of institutional care without compromising quality.Acta orthopaedica · 2018Article
- Reduced length of uninterrupted institutional stay after implementing a fast-track protocol for primary total hip replacement.Acta orthopaedica · 2018Article
- Fast track in hip arthroplasty.EFORT open reviews · 2017Article
- Review of perioperative falls.British journal of anaesthesia · 2016Review
- Preoperative Falls Predict Postoperative Falls, Functional Decline, and Surgical Complications.EBioMedicine · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTotal hip (THA) and knee arthroplasty (TKA) are common procedures in elderly persons, who are at potential increased risk of postoperative fall due to loss of muscle strength and impaired balance. Fast-track surgery with early mobilization and opioid-sparing analgesia have improved outcomes after these procedures, but early mobilization and short hospitalization length of stay (LOS) could potentially increase the risk of falls after discharge. We investigated injuries, circumstances, and the timing of fall-related hospital admissions 90 days after fasttrack THA and TKA.
methodsThis was a prospective, descriptive multicenter study on fall-related hospital admissions, in 5145 elective fast-track THA and TKA patients, with complete 90-day follow up through the Danish National Patient registry and medical charts.
resultsOf 83 (1.6%) fall-related hospital admissions, 43 (51.8%) were treated in the Emergency Room and 40 (48.2%) were admitted to a regular ward. The median LOS after surgery was 3 days (interquartile range [IQR]: 2-3) in fallers versus (vs) 2 days (IQR: 2-3) (P=0.022) in patients without falls. Injuries were classified as "none" or minor in 39.8%, moderate in 9.6%, and major in 50.6%. Most falls (54.8%) occurred within 1 month of discharge. Falls due to physical activity (12.0%) and extrinsic factors (14.5%) occurred later than did surgery-related falls (73.5%), contributing to 40% of all falls >30 days after discharge. In multivariate analysis, age (odds ratio [OR]: 1.05; 95% confidence interval [CI]: 1.0-1.08) (P=0.001), living alone (OR: 2.09; 95% CI: 1.20-3.62) (P=0.009), and psychiatric disease (OR: 2.80; 95% CI: 1.42-5.50) (P=0.001) were associated with surgery-related falls, whereas the use of a walking aid (OR: 1.20; 95% CI: 0.67-2.16) (P=0.544) and LOS ≤4 days (OR:1.19; 95% CI: 0.52-1.28) (P=0.680) was not.
conclusionHospital admissions due to falls are most frequent within the first month after fast-track THA and TKA. The overall incidence of surgery-related falls amongst these patients is low, declines after the first month, and is related to patient characteristics rather than short LOS. The effect of interventions aimed at surgery-related falls should focus on the first 30 days after surgery and differentiate between the causes of falling.
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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.