Factors Affecting Readmission Rates Following Primary Total Hip Arthroplasty

Mednick, Rachel E.; Alvi, Hasham M.; Krishnan, Varun; Lovecchio, Francis; Manning, David W.

doi:10.2106/jbjs.m.00556

Cited by 88 publications

(55 citation statements)

References 29 publications

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“…THA total hip arthroplasty, SNF skilled nursing facility, HHC home health care, IRF inpatient rehabilitation facility, LOS length of stay, DVT deep vein thrombosis, PE pulmonary embolism patients was 25.5 %, which is similar to the 22.2 % transfusion rate reported during a review of the ACS NSQIP [4]. The transfusion rate in the present study was 3.3 %.…”

Section: Other Outcomes Of Interestsupporting

confidence: 86%

“…The lower readmission rate could be due to a reduction in key complications following THA. A separate review of the ACS NSQIP reported THA patients with surgical site infections, thromboembolic events, or sepsis were at an increased risk for readmission [4]. In the present study, there were no instances of infection or sepsis and only a single thromboembolic event (0.2 %).…”

Section: Thirty-day Readmission Ratesupporting

confidence: 38%

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Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

Gofton

Chow

Olsen

et al. 2014

International Orthopaedics (SICOT)

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Purpose Recent studies have reported nearly 40 % of costs associated with a 30-day episode-of-care for total joint replacements are due to post-discharge activities and 81 % of those are specifically due to unplanned readmissions and discharging patients to post-acute care facilities. The purpose of this study was to determine these two key variables for total hip arthroplasty (THA) patients implanted using a tissuesparing surgical technique and to see how these values compare to those previously reported in the United States. Methods The healthcare databases at three institutions were searched for primary THA patients implanted using the supercapsular percutaneously-assisted total hip (SuperPath) surgical technique between January 2013 and July 2014. Data elements included 30-day all-cause readmission rate, discharge status, transfusion rate, complications, and length of stay (LOS). Results Data were available for 479 THAs. The 30-day allcause readmission rate, transfusion rate, and average LOS was 2.3, 3.3 %, and 1.6 days, respectively. Over 91 % of patients were discharged routinely home, 4.1 % to skilled nursing facilities, 3.8 % to home health care, and 0.6 % to inpatient rehabilitation facilities. Complications included dislocation (0.8 %), periprosthetic fracture (0.8 %), and deep vein thrombosis (0.2 %). There were no infections reported. Conclusions Patients implanted using this tissue-sparing technique experienced reduced 30-day all-cause readmission rates (2.3 % vs. 4.2 %) and more were routinely discharged home (91.5 % vs. 27.3 %) than have been previously reported for patients in the United States. Use of this tissue-sparing technique has the potential to significantly reduce post-discharge costs.

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Section: Other Outcomes Of Interestsupporting

confidence: 86%

Section: Thirty-day Readmission Ratesupporting

confidence: 38%

Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

Gofton

Chow

Olsen

et al. 2014

International Orthopaedics (SICOT)

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“…There is currently a limited amount of data that describes the postoperative complications of THA associated specifically with chronic corticosteroid use. Some studies have found that patients who take corticosteroids chronically are at increased risk for readmission [16], implant failure [15] and postoperative infection [5,13,22] after THA. However, other studies found no increases in the likelihood of readmissions for complications, including periprosthetic joint infection [2] and implant failure [4], after THA in this population.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the effect of chronic corticosteroid use on venous thromboembolism in this THA population is unknown and has been studied only indirectly in the context of how the specific inflammatory disease affects venous thromboembolism [13,21]. These studies were either single-center analyses limited by relatively small sample sizes and questionable generalizability, or large database studies documenting corticosteroid use but not performing further subanalyses using matched cohorts that make inferences regarding readmission or revision rates or complications like venous thromboembolism [2,4,5,13,15,16,21,22]. We therefore sought to use a large, multihospital, statewide healthcare database to investigate whether chronic corticosteroid use would be associated with an increased risk of complications after THA by casematching patients receiving long-term corticosteroids who underwent THA with patients who were not taking corticosteroids at the time of their hip procedures.…”

Section: Introductionmentioning

confidence: 99%

“…Fisher's exact tests (sex, hip osteonecrosis), chi-square tests (race), and independent sample t-tests (age, Charlson and Deyo comorbidity score) were used to calculate the significance of demographic differences between chronic corticosteroid users and the comparison cohort. : Chronic corticosteroid users were younger (mean, 63 [SD,16] We compared the date of the primary THA with the date of hospital admission (readmission, venous thromboembolism) or the date of surgery (revision hip arthroplasty) to identify the duration between the primary THA and the outcomes of interest. Endpoints for readmission and venous thromboembolism included 30 and 90 days.…”

Section: Introductionmentioning

confidence: 99%

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Does Chronic Corticosteroid Use Increase Risks of Readmission, Thromboembolism, and Revision After THA?

Boylan

Perfetti

Elmallah

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Systemic corticosteroids are commonly used to treat autoimmune and inflammatory diseases, but they can be associated with various musculoskeletal problems and disorders. There currently is a limited amount of data describing the postoperative complications of THA associated specifically with chronic corticosteroid use. Questions/purposes For chronic corticosteroid users undergoing THA, we asked: (1) What is the risk of hospital readmission at 30 and 90 days after surgery? (2) What is the risk of venous thromboembolism at 30 and 90 days after surgery? (3) What is the risk of revision hip arthroplasty at 12 and 24 months after surgery? Methods We identified patients in the Statewide Planning and Research Cooperative System who underwent primary THA between January 2003 and December 2010. This database provides hospital discharge abstracts for all admissions in the state of New York each year. We used propensity scores to three-to-one match the 402 chronic corticosteroid users with a comparison cohort of 1206 patients according to age, sex, race, comorbidity score, year of surgery, and hip osteonecrosis. The risk of each outcome was compared between chronic corticosteroid users and the matched cohort. Because multiple comparisons were made, we considered p less than 0.008 as statistically significant. Results Readmission was more common for corticosteroid users at 30 days (odds ratio [OR], 1.45; 95% CI, 1.14-1.85; p = 0.003) and 90 days (OR, 1.37; 95% CI, 1.09-1.73; p = 0.007). Venous thromboembolism was not more frequent in corticosteroid users at 30 days (OR, 2.39; 95% CI, 1.08-5.26; p = 0.031) or 90 days (OR, 1.91; 95%

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Who Is at Risk for Periprosthetic Joint Infection?

Tan

Kheir

Chen

2016

Periprosthetic Joint Infections

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Factors Affecting Readmission Rates Following Primary Total Hip Arthroplasty

Abstract: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 88 publications

References 29 publications

Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique

Does Chronic Corticosteroid Use Increase Risks of Readmission, Thromboembolism, and Revision After THA?

Who Is at Risk for Periprosthetic Joint Infection?

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