[Clinical audits of the procedure of the total hip arthroplasty and its impact on the improvement of the quality care].

Background: Clinical audits are critical and systematic quality analysis of medical care. Total hip arthroplasty (THA) is a routine practice and cost-effective, although there is little information on the quality of care of it.
Objective: To evaluate the impact of a clinical audit cycle in the quality of care in the primary THA procedures for non-traumatic cause.
Patients and Methods: A series of two audits (first audit in 2005 and second one in 2007) were performed. Patients of both sexes with non-traumatic primary THA and with a follow-up of 6 months were included. Time (days) in hospital stay and the rate (percentage) of readmissions were used as indicators of management; and as indicators of clinical practice: the index (percentage) of dislocation and the rate (percentage) of infection. Both audits were compared with respect to these indicators.
Results: A total of 160 patients (79 and 81, first and second audit respectively) were analysed. Management indicators: median (range) of hospital stay was 8 (7-78) and 7 (6-16), p<0.001, and the percentage of readmissions 5% (4/79) and 0 (0/81), p=0.057. Indicators of clinical practice: the rate of dislocation was 8% (6/79) and 0 (0/81), p=0.013, and the rate of infection 1% (1/79) and 1% (1/81), p=1. A multivariate analysis did not find other factors related to these indicators.
Conclusions: The implementation of a clinical audit cycle has improved the quality of care of primary THA procedures for non-traumatic cause.
(Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.)