Efficacy evaluation of a protocol for safe hip surgery (total hip arthroplasty)☆

Barros, Antônio Augusto Guimarães; Mendes, Carlos Henrique Cardoso; Temponi, Eduardo Frois; Costa, Lincoln Paiva; Vassalo, Carlos Cesar; Guedes, Euler de Carvalho

doi:10.1016/j.rboe.2017.08.004

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Revista Brasileira de Ortopedia

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Sumário

Artigos Originais • Rev. bras. ortop. 52 (suppl 1) • 2017 • https://doi.org/10.1016/j.rboe.2017.08.004 copy

Efficacy evaluation of a protocol for safe hip surgery (total hip arthroplasty)^☆ ☆ Study conducted at Hospital Madre Teresa, Belo Horizonte, MG, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To propose a multidisciplinary protocol to standardize the care of patients undergoing total hip arthroplasty (THA) and evaluate it effectiveness after implementation.

Methods

Retrospective evaluation of 95 consecutive patients undergoing THA divided into two groups, one group of 47 patients operated before the protocol implementation and 48 after.

Results

Assessing the re-admission rate, among 47 patients evaluated prior to implementation of the protocol, seven (14.9%) were re-admitted, and when observing the 48 patients evaluated after implementation, one (2.1%) was re-admitted, showing statistical significance (p < 0.05). The chance of re-admission before the protocol was eight times the chance of hospitalization after implementation (95% CI: 1.01 to 377.7). By comparing the clinical complications among the groups, it was observed that there was a lower rate of complications following implementation of the protocol (p = 0.006).

Conclusion

The introduction of a multidisciplinary protocol to standardize the management of patients undergoing THA decreased the rates of rehospitalization and clinical complications after the procedure.

Keywords:
Hip arthroplasty; Protocols; Postoperative complications; Hospitalization

Characteristics	Protocol implementation		p-value
	Before	After
Gender, n (%)			0.467^a a Pearson's chi-squared test.
Female	27 (57.5)	24 (50.0)
Male	20 (42.5)	24 (50.0)

Age (mean ± SD [median])	69.7 ± 16.1 (71.0)	66.7 ± 14.2 (68.5)	0.329^b b Student's t-test.
No. of comorbidities (mean ± SD [median])	0.6 ± 1.1 (0.0)	0.9 ± 1.3 (0.0)	0.130^b b Student's t-test.

Characteristics	Protocol implementation		p-value
	Before	After
Hospital stay in days (mean ± SD [median])	6.3 ± 4.7 (5.0)	5.1 ± 2.9 (5.0)	0.152^a a Student's t-test.

ER visits			0.125^b b Pearson's chi-squared test.
Yes	9 (19.2)	4 (8.3)
No	38 (80.8)	44 (91.7)

Re-admission, n (%)			0.030^a a Student's t-test.
Yes	7 (14.9)	1 (2.1)
No	40 (85.1)	47 (97.9)

90-day mortality, n (%)			0.495^a a Student's t-test.
Yes	0 (0.0)	2 (4.2)
No	47 (100.0)	46 (95.8)

Thrombosis, n (%)			0.495^a a Student's t-test.
Yes	1 (2.1)	0 (0.0)
No	46 (97.9)	48 (100.0)

90-day clinical complications, n (%)			0.006^a a Student's t-test.
Yes	7 (14.9)	0 (0.0)
No	40 (85.1)	48 (100.0)

Infection, n (%)			0.242^a a Student's t-test.
Yes	2 (4.3)	0 (0.0)
No	45 (95.7)	48 (100.0)

Dislocation, n (%)			0.242^a a Student's t-test.
Yes	2 (4.3)	0 (0.0)
No	45 (95.7)	48 (100.0)

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] *Corresponding author. antonioagbarros@gmail.com (A.A. Barros).

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Efficacy evaluation of a protocol for safe hip surgery (total hip arthroplasty)☆ ☆ Study conducted at Hospital Madre Teresa, Belo Horizonte, MG, Brazil.

Abstract

Objective

Methods

Results

Conclusion

Efficacy evaluation of a protocol for safe hip surgery (total hip arthroplasty)^☆ ☆ Study conducted at Hospital Madre Teresa, Belo Horizonte, MG, Brazil.