Félix I, Fritzsche K; Hospital for Special Surgery, Rehabilitation Department, N.Y., NY. igf17@yahoo.com.

PURPOSE: The purpose of the study was to determine if there are pre-operative predictors that indicate a patients discharge destination from the acute care setting, following primary total hip arthroplasty (THA). Previous studies have demonstrated that various predictors such as age, sex, body mass index, support systems, post-operative function and co-morbidities influence a patient’s discharge destination. In this study, the role of pre-operative function will be examined. SUBJECTS: 230 THA patients admitted to Hospital for Special Surgery (HSS) were included. Inclusion criteria consisted of 1) admitting diagnosis of osteoarthritis 2) primary, unilateral, hybrid THA and 3) physical therapy orders for THA protocol/weight bearing as tolerated. Exclusion criteria included lower extremity amputees or any serious neurological involvement. One hundred forty-two subjects were discharged directly home and 88 were discharged to an inpatient rehabilitation center. METHODS: This was a prospective, longitudinal descriptive study. The data was collected from completed HSS THA functional milestone forms. This form has been previously proven to be valid and reliable. Information on the form included age, height, weight, sex, type of hip prosthesis, weight bearing status as well as following 1) distance ambulated prior to surgery 2) the use of an assistive device prior to surgery 3) the need to negotiate stairs and 4) if the patient lives alone. ANALYSIS: A multiple regression analysis was used between dependent variables and predictor variables with Windows KWIKSTAT and SPSS. Statistics run for each group was the Chi-Square and Pearson’s Correlation. RESULTS: Significant differences were found between the two groups in the following categories: (1) pre-operative ambulation distance p = 0.042 (2) device used for ambulation pre-operatively p = 0.025 (3) lives alone p = 0.001 (4) age p = 0.001. CONCLUSIONS: Predictors do exist that help determine whether a patient following a THA is more likely to be discharged home or to an inpatient rehabilitation center. In this study, patients discharged to rehabilitation centers were predominantly older, female, lived alone, presented with four or more co-morbidities and ambulated shorter distances using a walker, pre-operatively. FUNDING SOURCE: None.

Copyright 2004 by the American Physical Therapy Association

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