Study Says Same Day Discharge After Orthopedic Surgery Safe for A-Fib Patients

Hoag Orthopedic Institute (HOI) physician Nader A. Nassif, MD, presented a study at the recent 2025 American Academy of Orthopaedic Surgeons annual meeting indicating that same-day discharge after joint replacement surgery is feasible in patients with atrial fibrillation (AF). A 2018 study found roughly 13% of cases of AF in the United States are undiagnosed, creating a potential risk for any surgical procedure.

“AF has historically been a known risk factor for perioperative complications,” said Dr. Nassif, division chief of joint replacement at the Hoag Orthopedic Institute, and study lead. “We looked at our patients with known atrial fibrillation, who we typically kept overnight, and asked ourselves if those overnight stays added any benefit to their outcomes.”

Nassif and his colleagues’ study looked at a cohort of patients with total joint replacement and AF and compared them with those without diagnosed arrhythmias who were discharged the same day. Outcomes of interest were visits to the emergency department, readmissions to the hospital and cardiac events.

Patients were stratified into one of two cohorts of 761 patients each: those with a history of AF who were admitted as inpatients and those with no history of AF who were discharged on the day of surgery. The investigation found that a preoperative diagnosis of AF was not a significant predictor of cardiac events in the first 24 hours after surgery.

“Outpatient joint replacement with same-day discharge is becoming increasingly more popular,” added Dr. Nassif. “Our research indicated that when appropriate care is provided for patients with AF, there is no increased risk of complications due to early discharges.”