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COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty

The COVID-19 pandemic caused major disruptions to the healthcare system, but its impact on the transition to same-day discharge shoulder arthroplasty remains unexplored. This study assessed the effect of COVID-19 on length of stay (LOS), same-day discharge rates, and other markers of resource use af...

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Autores principales: Menendez, Mariano E., Keegan, Noah, Werner, Brian C., Denard, Patrick J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709337/
https://www.ncbi.nlm.nih.gov/pubmed/34945204
http://dx.doi.org/10.3390/jcm10245908
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author Menendez, Mariano E.
Keegan, Noah
Werner, Brian C.
Denard, Patrick J.
author_facet Menendez, Mariano E.
Keegan, Noah
Werner, Brian C.
Denard, Patrick J.
author_sort Menendez, Mariano E.
collection PubMed
description The COVID-19 pandemic caused major disruptions to the healthcare system, but its impact on the transition to same-day discharge shoulder arthroplasty remains unexplored. This study assessed the effect of COVID-19 on length of stay (LOS), same-day discharge rates, and other markers of resource use after elective total shoulder arthroplasty. A total of 508 consecutive patients undergoing elective primary total shoulder arthroplasty between 2019 and 2021 were identified and divided into 2 cohorts: “pre-COVID” (March 2019–March 2020; n = 263) and “post-COVID” (May 2020–March 2021; n = 245). No elective shoulder arthroplasties were performed at our practice between 18 March and 11 May 2020. Outcome measures included LOS, same-day discharge, discharge location, and 90-day emergency department (ED) visits, readmissions and reoperations. There were no significant differences in baseline preoperative patient characteristics. Shoulder arthroplasty performed post-COVID was associated with a shorter LOS (12 vs. 16 h, p = 0.017) and a higher rate of same-day discharge (87.3 vs. 79.1%, p = 0.013). The rate of discharge to skilled nursing facilities was similarly low between the groups (1.9 vs. 2.0%, p = 0.915). There was a significant reduction in the rate of 90-day ED visits post-COVID (7.4 vs. 13.3%, p = 0.029), while there were no differences in 90-day reoperation (2.0 vs. 1.5%, p = 0.745) or readmission rates (1.2 vs. 1.9%, p = 0.724). The COVID-19 pandemic seems to have accelerated the shift towards shorter stays and more same-day discharge shoulder arthroplasties, while reducing unexpected acute health needs (e.g., ED visits) without adversely affecting readmission and reoperation rates.
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spelling pubmed-87093372021-12-25 COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty Menendez, Mariano E. Keegan, Noah Werner, Brian C. Denard, Patrick J. J Clin Med Article The COVID-19 pandemic caused major disruptions to the healthcare system, but its impact on the transition to same-day discharge shoulder arthroplasty remains unexplored. This study assessed the effect of COVID-19 on length of stay (LOS), same-day discharge rates, and other markers of resource use after elective total shoulder arthroplasty. A total of 508 consecutive patients undergoing elective primary total shoulder arthroplasty between 2019 and 2021 were identified and divided into 2 cohorts: “pre-COVID” (March 2019–March 2020; n = 263) and “post-COVID” (May 2020–March 2021; n = 245). No elective shoulder arthroplasties were performed at our practice between 18 March and 11 May 2020. Outcome measures included LOS, same-day discharge, discharge location, and 90-day emergency department (ED) visits, readmissions and reoperations. There were no significant differences in baseline preoperative patient characteristics. Shoulder arthroplasty performed post-COVID was associated with a shorter LOS (12 vs. 16 h, p = 0.017) and a higher rate of same-day discharge (87.3 vs. 79.1%, p = 0.013). The rate of discharge to skilled nursing facilities was similarly low between the groups (1.9 vs. 2.0%, p = 0.915). There was a significant reduction in the rate of 90-day ED visits post-COVID (7.4 vs. 13.3%, p = 0.029), while there were no differences in 90-day reoperation (2.0 vs. 1.5%, p = 0.745) or readmission rates (1.2 vs. 1.9%, p = 0.724). The COVID-19 pandemic seems to have accelerated the shift towards shorter stays and more same-day discharge shoulder arthroplasties, while reducing unexpected acute health needs (e.g., ED visits) without adversely affecting readmission and reoperation rates. MDPI 2021-12-16 /pmc/articles/PMC8709337/ /pubmed/34945204 http://dx.doi.org/10.3390/jcm10245908 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Menendez, Mariano E.
Keegan, Noah
Werner, Brian C.
Denard, Patrick J.
COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty
title COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty
title_full COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty
title_fullStr COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty
title_full_unstemmed COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty
title_short COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty
title_sort covid-19 as a catalyst for same-day discharge total shoulder arthroplasty
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8709337/
https://www.ncbi.nlm.nih.gov/pubmed/34945204
http://dx.doi.org/10.3390/jcm10245908
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