Days alive and out of hospital after fast-track total hip and knee arthroplasty: an observational cohort study in 16 137 patients

Days alive and out of hospital (DAH) has been proposed as a pragmatic outcome measure of surgical quality. However, there is a lack of procedure specific data or data within an optimised fast-track protocol. Furthermore, information about influence of follow-up duration and types of complications on DAH is limited. Observational multicentre cohort study of patients undergoing fast-track total hip (THA) and knee arthroplasty (TKA). Prospective information on comorbidity and complete 90 days follow-up was undertaken through the Danish National Patient Register and chart review. For 16 137 procedures, of which 18.6% were high-risk (≥2 preoperative risk factors), the median length of stay was 2 days (inter-quartile range [IQR], 2–3), and 30- and 90-day readmission rates were 5.7% and 8.1%, respectively. Median DAH30 and DAH90 days were 27 (26–28) and 87 (85–88) vs 28 (27–28) and 88 (87–89) (P25 and >85 at 30 and 90 days after operation, respectively. Median DAH in fast-track THA/TKA patients is 28 at 30 days and 88 at 90 days after surgery. DAH in high-risk patients was only slightly reduced compared with low-risk patients, but they have relatively more ‘medical’ complications.