Abstract
We sought to investigate the impact of incremental perioperative recovery protocol changes on hospital LOS and readmission rates associated with primary THAs. A total of 1751 cases were assigned to one of four protocol cohorts across 13 years: traditional, enhanced pain management, early mobility, and rapid recovery (RR). LOS significantly decreased between sequential eras and by 52% between the traditional and RR pathways (IRR=0.48; 95% CI 0.44, 0.53; P<0.0001) without an overall increase in 30-day readmission rates (P=0.13). The odds of readmission for THAs performed under the RR pathway were almost one-third those of the traditional era (OR=0.36; 95% CI 0.14, 0.93; P=0.04). Accelerated clinical care protocols should be considered for most patients undergoing primary THA.
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