Fast-track pathway for reduction of dislocated hip arthroplasty reduces surgical delay and length of stay

Figures & data

Table 1. Demographics

	Regular pathway	Fast-track pathway	p-value
Age, median (IQR)	76 (66–83)	78 (69–83)	0.1
Sex, n (%)
Male	68 (32)	49 (26)	0.2
Female	146 (68)	139 (74)
ASA score, n (%)
1	20 (10)	10 (5)	0.4
2	147 (69)	138 (73)
3	46 (22)	38 (20)
4	1 (0)	2 (1)
Arthroplasty type, n (%)
THA	194 (91)	166 (88)	0.4
Hemiarthroplasty	20 (9)	22 (12)
Reduction type, n (%)
Closed	212 (99)	187 (100)	0.6
Open	2 (1)	1 (0)

Figure 1. The regular pathway and fast-track pathway for reduction of a suspected dislocated hip arhtroplasty.

Table 2. Length of stay and surgical delay for all patients. Values are median (IQR)

	Regular pathway	Fast-track pathway	p-value
Surgical delay^a	4.1 (2.8–6.8)	2.5 (1.5–3.7)	< 0.001
Length of stay^b	31 (23–60)	26(19–52)	0.03

^a Surgical delay was defined as hours from examination in the ER until start of surgery.

^b Length of stay was defined as hours from examination in the ER until discharge.

Table 3. Complications as identified in patient records. Values are number (percentage)

	Regular pathway (n = 214)	Fast-track pathway (n = 188)	p-value
Intraoperative complications
None	206 (96)	185 (98)	0.2
Fracture	0 (0)	1 (0)
Failed reduction	8 (4)	2 (1)
In-hospital complications
None	181 (85)	167 (89)	0.1
Pulmonary^a	1 (0)	1 (0)
Cardiac^b	2 (1)	4 (2)
Thromboembolic^c	2 (1)	0 (0)
Nerve damage^d	1 (0)	0 (0)
Re-dislocation^e	7 (3)	10 (5)
Other^f	20 (9)	6 (3)

^a Pulmonary includes edema and pneumonia.

^b Cardiac includes acute coronary event, atrial fibrillation, etc.

^c Thromboembolic includes deep vein thrombosis and pulmonary embolism.

^d Nerve damage: ischial nerve damage after reduction.

^e Re-dislocation: re-dislocation while still admitted.

^f Other: urinary tract infections, delirium, and psychosis.