The purpose of this study is to investigate if the consumption of a complex carbohydrate drink preoperatively, decreases the length of stay and causes for failure to launch in patients undergoing ambulatory total joint arthroplasty.
The way total joint arthroplasty is practiced continues to evolve as CMS removed total hip arthroplasty (THA) from the inpatient-only list and added total knee arthroplasty (TKA) to the ASC Covered Surgical Procedures List (CPL) in 2020. Thus, surgeons must find subtle interventions that improve patient outcomes while minimizing the risk of adverse reactions. Current literature has not assessed the influence of preoperative hydration, using a complex carbohydrate drink, on the same-day discharge rate and causes for failure to launch. Considering variabilities in perioperative fluid management leading to postoperative nausea, vomiting, and dizziness, the investigators seek to reduce the incidence of these events by optimizing patients using a preoperative oral hydration protocol, reducing the length of stay, and improving same-day discharge rates.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
312
Patients will drink a complex carbohydrate drink 3 hours before surgery. Drink to be given at the preoperative holding area.
Hospital for Special Surgery
New York, New York, United States
RECRUITINGLength of hospital stay in hours
Length of hospital stay in hours, assess by medical record.
Time frame: From admission to discharge, up to 1 week
Same day discharge rate
Percentage of patients discharged successfully the day of surgery.
Time frame: Through study completion, an average of 3 months.
Number of physical therapy sessions attempted
Number of physical therapy sessions attempted, assess by medical record.
Time frame: From admission to discharge, up to 1 week.
Total distance walked
Total distance walked during physical therapy attempts, assess by medical record.
Time frame: From admission to discharge, up to 1 week.
Number of stairs climbed
Number of stairs climbed during physical therapy attempts, assess by medical record.
Time frame: From admission to discharge, up to 1 week.
Orthostatic hypotension episodes
Orthostatic hypotension episodes during physical therapy attempts, assess by medical record.
Time frame: During physical therapy attempts, from admission to discharge.
HOOS JR Score
This is a 6-item questionnaire that assesses patient-reported hip pain and function. Score ranges from 0-100, with 100 representing the best possible score.
Time frame: The morning of surgery and at the first post-operative visit, up to 4 months post-op.
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KOOS JR Score
This is a 6-item questionnaire that assesses patient reported knee pain and function. Score ranges from -100, with 100 representing the best score possible.
Time frame: The morning of surgery and at the first post-operative visit, up to 4 months post-op.
VR-12 Score
The VR-12 is a 12-item self-reported questionnaire that assesses the patient physical and mental quality of life.
Time frame: The morning of surgery and at the first post-operative visit, up to 4 months post-op.
Urine osmolality
Urine osmolality taken preoperatively, assess by medical record.
Time frame: Measured preoperatively the morning of surgery.
Urine specific gravity
Urine specific gravity preoperatively, assess by medical record.
Time frame: Measured preoperatively the morning of surgery.
In-house costs
In-house costs taking into account cost of complex carbohydrate drink vs previously published costs savings per night of stay.
Time frame: From admission to discharge, up to 1 week.