Evidence map›Paper›PMID 30021552›Full record

Observational studyBMC musculoskeletal disorders2018

The effectiveness of inpatient rehabilitation after uncomplicated total hip arthroplasty: a propensity score matched cohort.

Justine M Naylor, Andrew Hart, Rajat Mittal, Ian A Harris, Wei Xuan

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC musculoskeletal disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01899443 (Improving Services and Outcomes for Joint Replacement Patients), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing 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.

NCT01899443 completednot on this map

Improving Services and Outcomes for Joint Replacement Patients

TypeobservationalSponsorSouth West Sydney Local Health DistrictRan2013 to 2016Enrolled1,900ConditionsOsteoarthritisArmsObservation
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Article
  3. Article
  4. Article
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  8. Review
  9. 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

5 authors.

Justine M NaylorSouth Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Elizabeth Drive, Liverpool, NSW, 2170, Australia. Justine.Naylor@health.nsw.gov.au.ORCID http://orcid.org/0000-0002-9147-1312
Andrew HartSouth Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Elizabeth Drive, Liverpool, NSW, 2170, Australia.
Rajat MittalSouth Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Elizabeth Drive, Liverpool, NSW, 2170, Australia.
Ian A HarrisSouth Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Elizabeth Drive, Liverpool, NSW, 2170, Australia.
Wei XuanSouth Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Elizabeth Drive, Liverpool, NSW, 2170, Australia.

Funding

HCF Research Foundation IHIIAMR2012073043
6 · The paper itself

Abstract

backgroundInpatient rehabilitation is an expensive option following total hip arthroplasty (THA). We aimed to determine if THA patients who receive inpatient rehabilitation report better hip and quality of life scores post-surgery compared to those discharged directly home.

methodsProspective, propensity score matched cohort involving 12 private hospitals across five Australian States. Patients undergoing THA secondary to osteoarthritis were included. Those receiving inpatient rehabilitation for reasons other than choice or who experienced significant health events within 90-days post-surgery were excluded. Comparisons were made between those who did and did not receive inpatient rehabilitation for patient-reported hip pain and function (Oxford Hip Score, OHS) and 'today' health rating (EuroQol 0-100 scale). Rehabilitation provider charges were also estimated and compared.

resultsTwo hundred forty-six patients (123 pairs, mean age 67 (10) yr., 66% female) were matched on 19 covariates for their propensity to receive inpatient rehabilitation. No statistically nor clinically significant between-group differences were observed [OHS median difference (IQR): 0 (- 3, 3), P = 0.60; 0 (- 1 to 1), P = 0.91, at 90 and 365-days, respectively; EuroQol scale median difference 0 (- 10, 12), P = 0.24; 0 (- 10, 10), P = 0.49; 5 (- 10, 15), P = 0.09, at 35-, 90- and 365-days, respectively]. Median rehabilitation provider charges were 10-fold higher for those who received inpatient rehabilitation [median difference $7582 (5649, 10,249), P <  0.001]. Sensitivity analyses corroborated the results of the primary analyses.

conclusionUtilization of inpatient rehabilitation pathways following THA appears to be low value healthcare. Sustainability of inpatient rehabilitation models may be enhanced if inpatient rehabilitation is reserved for those most impaired or who have limited social supports.

trial registrationClinicalTrials.gov Identifier: NCT01899443 .

Indexed as

Propensity ScoreAgedArthroplasty, Replacement, HipCohort StudiesFemaleHospitalizationHospitals, PrivateHospitals, RehabilitationHumansInpatientsMaleMiddle AgedProspective StudiesTreatment OutcomeArthroplastyHipPhysical therapyRehabilitation

Identifiers

PMID30021552
PMCPMC6052669

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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.