Evidence map›Paper›PMID 39172260›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Outpatient vs. inpatient designation in total hip arthroplasty: can we predict who will require hospitalization?

Patrick Connolly, Jeremiah Thomas, Thomas Bieganowski, Ran Schwarzkopf, Claudette M Lajam, Roy I Davidovitch, Joshua C Rozell

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
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

7 authors.

Patrick ConnollyDepartment of Orthopaedic Surgery, NYU Langone Health, NYU Langone Orthopaedic Hospital, 301 East 17th Street, New York, NY, 10003, USA.
Jeremiah ThomasDepartment of Orthopaedic Surgery, NYU Langone Health, NYU Langone Orthopaedic Hospital, 301 East 17th Street, New York, NY, 10003, USA.
Thomas BieganowskiDepartment of Orthopaedic Surgery, NYU Langone Health, NYU Langone Orthopaedic Hospital, 301 East 17th Street, New York, NY, 10003, USA.
Ran SchwarzkopfDepartment of Orthopaedic Surgery, NYU Langone Health, NYU Langone Orthopaedic Hospital, 301 East 17th Street, New York, NY, 10003, USA.
Claudette M LajamDepartment of Orthopaedic Surgery, NYU Langone Health, NYU Langone Orthopaedic Hospital, 301 East 17th Street, New York, NY, 10003, USA.
Roy I DavidovitchDepartment of Orthopaedic Surgery, NYU Langone Health, NYU Langone Orthopaedic Hospital, 301 East 17th Street, New York, NY, 10003, USA.
Joshua C RozellDepartment of Orthopaedic Surgery, NYU Langone Health, NYU Langone Orthopaedic Hospital, 301 East 17th Street, New York, NY, 10003, USA. Joshua.Rozell@nyulangone.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFollowing removal of total hip arthroplasty (THA) from the inpatient only (IPO) list by the Center for Medicare Services (CMS), arthroplasty surgeons face increased pressure to perform procedures on an outpatient (OP) basis. The purposes of the present study were to compare patients booked for THA as OP who required conversion to IP status postoperatively, to patients who were booked as, and remained OP, and to identify factors predictive of conversion from OP to IP status.

methodsWe retrospectively reviewed all patients who underwent a primary THA at our institution between January 1, 2020 and April 26, 2022. All patients included were originally scheduled for OP surgery and were separated based on conversion to IP status postoperatively. Multiple regression analyses were used to determine the significance of all perioperative variables. Modeling via binary logistic regressions were used to determine factors predictive of status conversion.

resultsOf 1,937 patients, 372 (19.2%) designated as OP preoperatively required conversion to IP status postoperatively. These patients had significantly higher facility discharge rates (P < 0.001) and 90-day readmission rates (P = 0.024). Patients aged 65 and older (P < 0.001), females (P < 0.001), patients with Black/African American race (P = 0.027), with a recovery room arrival time after 12 pm (P < 0.001), with a BMI > 30 kg/m2 (P = 0.001), and with a Charlson Comorbidity Index (CCI) ≥ 4 (P = 0.013) were Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation more likely to require conversion to IP designation. Marital status and time of procedure were also significant factors, as patients who were married (P < 0.001) and who were the first case of the day (P < 0.001) were less likely to be converted to IP.

conclusionSeveral factors were identified which could help determine appropriate hospital designation status at the time of surgical booking to ultimately avoid insurance claim denials. These included BMI, certain demographic factors, CCI ≥ 4, and patients 65 or older. LEVEL III EVIDENCE: Retrospective Cohort Study.

Indexed as

Arthroplasty, Replacement, HipAgedAmbulatory Surgical ProceduresFemaleHospitalizationHumansInpatientsMaleMiddle AgedRetrospective StudiesUnited StatesInpatientInpatient Only ListOutpatientTotal Hip Arthroplasty

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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.