Authors (including presenting author) :
YPJ Wong(1), YWJ Chao(1), HY Chan(1), TC Chan(1), MLM Lee(1), SP Wong(1), PK Chan(2), CH Yan(2), KY Chiu(2)
Affiliation :
1 Occupational Therapy Department, Queen Mary Hospital
2 Department of Orthopaedics and Traumatology, Queen Mary Hospital
Introduction :
While length of stay (LOS) have been extensively studied, little attention has been paid at the use of functional discharge indicator. The aim of this article is to determine if independent toileting (Toilet Days) could be used as a functional discharge indicator in patients with total knee arthroplasty (TKA) and total hip arthroplasty (THA).
Objectives :
Post-operation independent toileting has been used as the functional discharge criteria as it requires high physical and mental demand, which include to manage the lower garment, transfer, ambulation, judgement and safety awareness. Patients who can perform independent toileting is expected to be discharged home sooner. However, there is no local studies on the use of independent toileting and LOS in patients with TKA and THA.
Methodology :
All records with THA and TKA done in 2019 at Queen Mary Hospital were analyzed.
Apart from the post-operation daily Activity of Daily Living (ADL) training in dressing lower garment, toilet transfer, and the use of assistive device, post-operation Toilet Days is captured for each case.
The Toilet Days, age, gender, social support, and type of operations were included in multiple regression to identify the predictors for post-operation LOS in an acute hospital.
Result & Outcome :
A total of 305 cases (198 females, 107 males) were captured, mean age 68 ± 11.4 (17-97). Seventy percent received TKA while the other thirty percent received THA.
The mean Toilet Days is 3.2 ± 2.7 days (TKA: 2.8 ± 2.9days; THA: 3.9 ± 2.1 days with statistically significant p=0.004).
Multiple regression shows that Toilet Days is the only statistically significant predicting factor in the LOS (F (5,255) = 18.87, p< 0.001, R2=0.27), with positive correlation (r=0.52, p< 0.0001). The prediction formula for Predicted LOS is 2.57 + 0.72 (Toilet Days) + 0.28(Gender) + 0.004(Age) + 0.05(Type of operation) + 0.38(Social support).
Conclusion:
This study indicated that independent toileting could be used as a functional discharge indicator. Patients who can manage independent toileting is more confident to return home. Intensive post operation ADL training especially in toilet use is crucial in promoting early and safe discharge home.
