2017 ISAKOS Biennial Congress ePoster #1289
Patients Discharged to an Inpatient Rehabilitation Facility after Total Knee Arthroplasty Undergo More Diagnostic Interventions with no Improvement in Short-Term Outcomes or Patient Satisfaction
Peter B. White, DO, Plainview, NY UNITED STATES
Alberto Carli, MD
Narges Ghazi, MS, New York, NY UNITED STATES
Morteza Meftah, MD, New York, NY UNITED STATES
Michael M. Alexiades, MD, New York, NY UNITED STATES
Russell E. Windsor, MD, New York, NY UNITED STATES
Amar S. Ranawat, MD, New York, NY UNITED STATES
Hospital for Special Surgery, New York, UNITED STATES
FDA Status Cleared
Summary
This study evaluated differences in postoperative care for patients discharged to home versus in-patient rehabilitation facilities
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Abstract
Background
Several studies have shown that functional outcomes for patients discharged to home are similar to those for patients discharged to in-patient rehabilitation facilities (IRFs). Therefore, we sought to determine if there is a difference in the number of diagnostic tests, interventions, pain and function scores or patient satisfaction for patients discharged to IRFs or to home.
Methods
From February to May of 2015, 171 consecutive patients were prospectively recruited following primary TKA by one of three high volume arthroplasty surgeons. At six-weeks post TKA, patients completed a questionnaire to determine the number and types of diagnostic imaging tests, blood transfusions and overall patient satisfaction whether discharged to IRFs (n=85) or to home (n=86). Readmission rates, Knee Society pain and function scores were collected at the same outpatient visit and were compared with preoperative scores.
Results
A significantly greater proportion of patients discharged to IRFs reported undergoing at least one diagnostic imaging test compared to patients discharged home (25.8% vs. 8.1%; p=0.032). Multivariate logistic regressions revealed that patients discharged to an IRF were more likely to have a greater number of diagnostic tests (OR: 5.01; 95% CI: 1.69 to 14.9; p=0.004) and radiographs performed (OR: 16.1; 95% CI: 1.54 to 169.7; p=0.018). There was no significant difference in readmission rates for patients discharged to home (2.35%) or to an IRF (0%) (p=0.246).No significant differences were observed in postoperative KSS pain or function scores (p= 0.083 and p=0.057, respectively), or VAS Satisfaction scores (p=0.206). Twenty-nine (34.1%) patients were discharged under the care of the visiting nurse service after leaving the rehabilitation facility.
Conclusions
Patients discharged to an IRF underwent more diagnostic testing, especially radiographs, than patients discharged to home. There were no clinically relevant differences in KSS pain or function scores, or patient satisfaction.