Sex and Age Effects on Outcomes of Total Hip Arthroplasty After Inpatient Rehabilitation

Abstract

Vincent HK, Alfano AP, Lee L, Vincent KR. Sex and age effects on outcomes of total hip arthroplasty after inpatient rehabilitation. Objective To retrospectively examine the effects of sex and age on the inpatient rehabilitation outcomes of patients after total hip arthroplasty (THA). Design Exploratory, retrospective study. Setting A university-affiliated rehabilitation hospital. Participants Male and female THA patients (N=332) were stratified into age brackets (<65y, 65–84y, ≥85y). All patients completed interdisciplinary inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures Length of stay (LOS), FIM instrument scores, FIM efficiency (FIM/LOS), hospital costs, and discharge disposition location were collected by chart review. Results Regardless of age, women had lower FIM scores at admission and discharge than men ( P<.05). FIM efficiency was 22% to 53% lower for women in primary THA and 16% to 85% lower in revision THA than men ( P=.001). Women accrued higher total hospital charges than men ($13,099 vs $11,141; P<.05), and were discharged home less frequently than men (84.4% vs 90.9%; P<.05). Admission FIM scores were 10.6% and 8.9% lower and discharge FIM scores were 7.3% and 9.2% lower in patients 85 years or older than those less than 65 or 65 to 84 years ( P<.01). FIM efficiency was 25% to 38% higher in patients less than 85 years than those 85 years and older ( P=.015), and 37% higher in men than women ( P=.001). Patients 85 years and older were discharged less frequently to home than patients less than 85 years ( P<.05). Conclusions All patients made functional improvement after inpatient rehabilitation, but women and patients 85 years and older had longer LOS and lower FIM efficiency, incurred greater hospital charges, and were less likely to be discharged to home than men and younger counterparts.