Thirty-Day Readmission Following Total Hip and Knee Arthroplasty - A Preliminary Single Institution Predictive Model

被引:87
作者
Mesko, Nathan W. [1 ]
Bachmann, Keith R. [2 ]
Kovacevic, David [2 ]
LoGrasso, Mary E. [2 ]
O'Rourke, Colin [3 ]
Froimson, Mark I. [2 ]
机构
[1] Vanderbilt Univ, Med Ctr, Dept Orthopaed Surg, Nashville, TN 37232 USA
[2] Cleveland Clin, Dept Orthopaed Surg, Adult Reconstruct Sect, Cleveland, OH USA
[3] Lerner Res Inst, Cleveland, OH USA
关键词
30-day readmission; value-based healthcare; total joint arthroplasty; risk stratification; HOSPITAL READMISSION; PATIENT PREDICTORS; STATISTICAL-MODELS; GENERAL-ANESTHESIA; RATES; REPLACEMENT; FRACTURE; TRANSFUSION; MANAGEMENT; SURGERY;
D O I
10.1016/j.arth.2014.02.030
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
We sought to identify demographic or care process variables associated with increased 30-day readmission within the total hip and knee arthroplasty patient population. Using this information, we generated a model to predict 30-day readmission risk following total hip and knee arthroplasty procedures. Longer index length of stay, discharge disposition to a nursing facility, blood transfusion, general anesthesia, anemia, anticoagulation status prior to index admission, and Charlson Comorbidity Index greater than 2 were identified as independent risk factors for readmission. Care process factors during the hospital stay appear to have a large predictive value for 30-day readmission. Specific comorbidities and patient demographic factors showed less significance. The predictive nomogram constructed for primary total joint readmission had a bootstrap-corrected concordance statistic of 0.76. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:1532 / 1538
页数:7
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