CAS and Length of Hospital Stay After TKA

Cumulated Ambulation Score and Length of Hospital Stay After TKA

The purpose of the study is to prospectively evaluate patients who underwent total knee arthroplasty (TKA) using the Cumulated Ambulation Score (CAS)

Study Overview

• Status: Completed
• Conditions: CAS
• Intervention / Treatment: Other: CAS after primary and revision TKA

Detailed Description

The number of patients who receive a total knee arthroplasty (TKA) is steadily increasing and although the reliability and the results of this procedure are excellent, intensive functional rehabilitation is needed postoperatively to obtain satisfactory range of motion. Currently, the standard length of stay at our hospital is between 8 and 10 days for patients who undergo TKA.

The length of stay depends not only on factors such as early mobilization, pain management, major or minor complications and logistical or organizational problems (1) (2). It also depends on the availability of adequate services when the patient needs to be transferred to an appropriate facility. Each of these steps can be further developed in order to improve the quality of care for patients, reduce hospital costs and increase the availability of beds (3). As a result, the reduction in average length of stay would not only result in a reduction in cost but also a greater turnover in the number of patients. Several studies show that the application of a post-operative fast-track strategy may reduce the length of stay in a very significant manner with benefit for patients and hospitals (3).Thus, if their condition allows, patients would have rapid post-operative rehabilitation, with early joint mobilization at D0 (operative day) and walking from D1 (the first post-operative day).

The Cumulated Ambulation Score (CAS) (4) is a tool developed and tested for initial predicting the in-patient length of stay following a hip surgery. The CAS consists of documenting the patient's ability and independence while performing 3 basic daily activities (sit to stand, transfer out of bed and mobilization). It is calculated using a score of 0-2 for each parameter, giving a total daily score of 0 to 6 and a score of 0 to 18 during the first 3 post-operative days. The CAS is then the sum of scores of the first 3 post-operative days. This score proves to be an effective tool for predicting the length of stay, and other parameters investigated such as survival rate and return home after a proximal femoral surgery.

• Study Type: Observational
• Enrollment (Actual): 73

Contacts and Locations

Study Locations

• Switzerland
  • Vaud
    • Lausanne, Vaud, Switzerland, 1011
      • CHUV - Hopital Orthopedique

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

TKA patients just after surgery

Description

Inclusion Criteria: Adults after elective TKA -

Exclusion Criteria: No consent form signed, neurological impairment

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Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
CAS after primary and revision TKA; CAS and RAPT	Other: CAS after primary and revision TKA; CAS and RAPT

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
CAS value	Record the CAS values for the first three operative days as mentioned in the protocol	The 3rd day after TKA

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Length of stay	Record number of in-hospital days	between 4 days and 2 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Destination at the end of the hospitalisation	Record the patients' destination at the end of the in-hospital stay: home, rehabilitation centre, residential home or other.	at the moment of departure from in-hospital care

Collaborators and Investigators

• Sponsor: University of Lausanne Hospitals
• Investigators: Study Director: B Jolles, Prof., CHUV; Principal Investigator: Luís C Pereira, MSc, CHUV; Principal Investigator: Georgios Gkagkalis, Dr, CHUV

Study record dates

Study Major Dates

• Study Start: September 1, 2013
• Primary Completion (Actual): September 1, 2014
• Study Completion (Actual): June 1, 2015

Study Registration Dates

• First Submitted: September 17, 2013
• First Submitted That Met QC Criteria: December 20, 2013
• First Posted (Estimate): December 27, 2013

Study Record Updates

• Last Update Posted (Estimate): June 2, 2015
• Last Update Submitted That Met QC Criteria: June 1, 2015
• Last Verified: June 1, 2015

More Information

Terms related to this study

• Keywords: Length of stay; TKA; CAS; Rehabilitation localisation
• Other Study ID Numbers: CHUV 144/13; CaS (DAL TKA registry)