Living Alone is Predictive of Non-home Discharge Following Elective Total Hip Arthroplasty: a Matched-pairs Cohort Analysis

The goal of this observational study is to assess the effect of living alone on total hip arthroplasty thirty-day outcomes. The main questions it aims to answer are:

Is living alone associated with discharge disposition (home versus non-home)? Is living alone associated with greater incidences of secondary adverse events?

Participants will be sampled from the 2021 American College of Surgeons National Surgical Quality Improvement Program

Study Overview

• Status: Completed
• Conditions: Perioperative/Postoperative Complications; Arthropathy of Hip
• Intervention / Treatment: Behavioral: home support, hiving alone; Behavioral: home support, living with others

• Study Type: Observational
• Enrollment (Actual): 5677

Contacts and Locations

Study Locations

• United States
  • Virginia
    • Charlottesville, Virginia, United States, 22908
      • University of Virginia

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Elective total hip arthroplasty patients, ACS-NSQIP 2021

Description

Inclusion Criteria:

• Elective, non-emergent cases
• Living alone
• Living with others

Exclusion Criteria:

• Fracture in surgical diagnosis
• Hospital admission >1 day preoperatively
• End-stage renal disease (preoperative)
• Metastatic disease (preoperative)
• Sepsis (preoperative)
• Bleeding diathesis (preoperative)
• American Society of Anesthesiologists Physical Status Classification 5

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Living alone; 1,624 patients undergoing elective total hip arthroplasty who were living alone at the time of admission.	Behavioral: home support, hiving alone; Home support: living alone
Living with others; 1,624 patients undergoing elective total hip arthroplasty who were living with others at the time of admission.	Behavioral: home support, living with others; Home support: living with others

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Discharge disposition	Home versus non-home	Thirty days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bleeding events	Requiring transfusion	Thirty days
Requiring home services		Thirty days
Functional status at discharge	Dependent versus independent	Thirty days
Postoperative delirium		Thirty days
Hospital length of stay		Thirty days
Unplanned resource utilization	Unplanned readmission and return to the operating room	Thirty days
Wound complications	Superficial surgical site infection (SSI), deep incisional SSI, organ space SSI, and wound dehiscence	Thirty days
Systemic complications	Cardiac arrest, myocardial infarction, stroke, reintubation, pneumonia, deep venous thrombosis, pulmonary embolism, bleeding, sepsis, septic shock, and acute kidney injury	Thirty days
Mortality		Thirty days

Collaborators and Investigators

• Sponsor: University of Virginia
• Investigators: Principal Investigator: Zhiyi Zuo, MD, PhD, University of Virginia

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2021
• Primary Completion (Actual): January 30, 2022
• Study Completion (Actual): January 30, 2022

Study Registration Dates

• First Submitted: June 11, 2024
• First Submitted That Met QC Criteria: June 11, 2024
• First Posted (Actual): June 17, 2024

Study Record Updates

• Last Update Posted (Actual): June 18, 2024
• Last Update Submitted That Met QC Criteria: June 16, 2024
• Last Verified: June 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Postoperative Complications
• Other Study ID Numbers: HSRZOKZZ3

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS NSQIP are the source of the data used herein. The Participant Use Data File (PUF) is a Health Insurance Portability and Accountability Act (HIPAA)-compliant data file containing cases submitted to the American College of Surgeons National Surgical Quality Improvement Program®. To request a copy of the PUF, individuals (data recipients) must agree to comply with the terms and conditions set forth in the Data Use Agreement, provide contact information, and complete a short online questionnaire. Once the information provided by the data recipient is received and processed by ACS NSQIP staff, a website address will be submitted electronically to the data recipient. The data recipient will then have 10 days (240 hours) to visit the website and download the data file.

Study Data/Documents

1. Individual Participant Data Set

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No