背景:机械臂辅助在全髋关节置换术(THA)中持续流行,因为它有可能改善组件放置的准确性和患者的预后。尽管如此,关于机器人辅助THA(RA-THA)对住院时间(LOS)和出院地点的影响的数据有限.因此,本研究旨在比较LOS,放电位置,RA-THA与手动THA(M-THA)倾向匹配队列的再入院率。
方法:对多医院数据库进行回顾性审查,以确定在2016年1月至2021年12月期间接受THA的患者,这些患者来自在77家不同地理位置的医院进行RA-THA和M-THA的外科医生。RA-THA和M-THA队列根据患者性别1比1匹配,年龄,和身体质量指数,导致每个队列8,536名患者。保险类型,LOS,当天出院,放电处理,使用Mann-WhitneyU和卡方检验比较了90天全因再入院率。
结果:RA-THA患者的平均LOS(1.39±0.85天)明显短于M-THA患者(1.48±0.91天,P<0.001)。与5.6%的M-THA患者相比,5.3%的RA-THA患者当天出院(P=0.38)。队列之间的出院处置有统计学上的显着差异,与M-THA相比,更多的RA-THA病例在没有家庭保健的情况下出院(47.9对45.5%,P=0.001),与M-THA相比,出院到熟练护理机构(SNF)的RA-THA病例较少(5.6对6.9%,P=0.001)。RA-THA病例90天全因再入院率为3.0%,与M-THA病例的3.4%相比(P=0.26)。
结论:与M-THA相比,RA-THA的平均LOS较短,当天出院的患者比例相似,SNF出院的患者较少,和类似的全因90天再入院率。这些结果可能对参与捆绑支付计划并节省成本的外科医生感兴趣。
BACKGROUND: Robotic-arm assistance continues to gain popularity in total hip arthroplasty (THA) for its potential to improve component placement accuracy and patient outcomes. Nonetheless, there is limited data on the impact of robotic-assisted THA (RA-THA) on hospital length of stay (LOS) and discharge location. This study thus aimed to compare LOS, discharge location, and readmission rate for propensity-matched cohorts of RA-THA versus manual THA (M-THA).
METHODS: A retrospective review of a multi-hospital database was performed to identify patients who underwent THA between January 2016 and December 2021 from surgeons who performed both RA-THA and M-THA at 77 geographically diverse hospitals. The RA-THA and M-THA cohorts were 1-to-1 matched based on patient sex, age, and body mass index, resulting in 8,536 patients per cohort. Insurance type, LOS, same-day discharge, discharge disposition, and 90-day all-cause readmission rate were compared using Mann-Whitney U and Chi-square tests.
RESULTS: Average LOS was significantly shorter for RA-THA patients (1.39 ± 0.85 days) than for M-THA patients (1.48 ± 0.91 days, P < .001). Compared to 5.6% of M-THA patients, 5.3% of RA-THA patients underwent same-day discharge (P = .38). There were statistically significant differences in discharge disposition between cohorts, with more RA-THA cases discharged home without home healthcare compared to M-THA (47.9 versus 45.5%, P = .001) and fewer RA-THA cases discharged to a skilled nursing facility compared to M-THA (5.6 versus 6.9%, P = .001). The 90-day all-cause readmission rate for RA-THA cases was 3.0%, compared to 3.4% for M-THA cases (P = .26).
CONCLUSIONS: Compared to M-THA, RA-THA had a shorter average LOS, a similar percentage of patients with same-day discharge, fewer patients who had skilled nursing facility discharge, and a similar all-cause 90-day readmission rate. These results may be of interest to surgeons participating in bundled payment programs and engaging in cost savings.