Predictive Risk Factors for 30-day Readmissions Following Primary Total Joint Arthroplasty and Modification of Patient Management

被引:53
作者
Tayne, Samantha [1 ,3 ]
Merrill, Christian A. [1 ]
Smith, Eric L. [2 ]
Mackey, William C. [3 ]
机构
[1] Tufts Univ, Sch Med, Boston, MA 02111 USA
[2] Tufts Med Ctr, Dept Orthopaed Surg, Boston, MA 02111 USA
[3] Tufts Med Ctr, Dept Surg, Boston, MA 02111 USA
关键词
readmission; 30-day; primary total joint arthroplasty; risk factors; post-operative management; TOTAL KNEE ARTHROPLASTY; DISCHARGE; SURGERY; OBESITY; RATES; SEX; OUTCOMES; IMPACT;
D O I
10.1016/j.arth.2014.05.023
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
The Centers for Medicare and Medicaid have begun to publically publish statistics on readmissions following primary total hip (THA) and total knee arthroplasty (TKA). Our study retrospectively assesses 30-day readmissions rates following THA and TKA, performed by a single surgeon at a tertiary care medical center between 2007 and 2012. Results of a univariate analysis and logistic regression model indicated female gender, high ASA class, and increased operative time to be significantly associated with higher rates of readmission (OR 4.646, OR 1.257, and OR 5.323, respectively). Readmissions most often occurred within the first week of patient discharge. Surgical complications and gastrointestinal discomfort were the most common causes for readmission. Using readmission risk we can stratify patients into tiered critical care pathways to reduce readmissions. (c) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:1938 / 1942
页数:5
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