Clinical trial NCT02022410: CAS and Length of Hospital Stay After TKA
Official title: Cumulated Ambulation Score and Length of Hospital Stay After TKA
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: CAS
Keywords: CAS
Length of stay
Rehabilitation localisation
TKA
Lead sponsor: University of Lausanne Hospitals
Sponsor class: OTHER
First posted: 2013-12-27
Enrollment: 73
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: TKA patients just after surgery

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

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.

Eligibility criteria: Inclusion Criteria: Adults after elective TKA -

Exclusion Criteria: No consent form signed, neurological impairment

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Primary outcomes:
measure: CAS value
timeFrame: The 3rd day after TKA
Secondary outcomes:
measure: Length of stay
timeFrame: between 4 days and 2 weeks
Other outcomes:
measure: Destination at the end of the hospitalisation
timeFrame: at the moment of departure from in-hospital care
Locations:
city: Lausanne
country: Switzerland
facility: CHUV - Hopital Orthopedique
state: Vaud
Study officials:
affiliation: CHUV
name: B Jolles, Prof.
role: STUDY_DIRECTOR
affiliation: CHUV
name: Luis C Pereira, MSc
role: PRINCIPAL_INVESTIGATOR
affiliation: CHUV
name: Georgios Gkagkalis, Dr
role: PRINCIPAL_INVESTIGATOR
References: