Hospital Exposure Prior to Total Hip Arthroplasty: Are Perioperative Outcomes Impacted?

Abstract

As demand for total hip arthroplasty (THA) continues to grow, identifying risk factors for poor perioperative outcomes may help guide preoperative planning. Therefore, the aim of the present study was to determine the risk of adverse outcomes following THA after a preoperative health care event (PHE). This was a single-institution retrospective review of all patients who underwent primary THA from September 2011 to April 2022. Patients were stratified based on whether they had a PHE or not. PHEs were defined as an emergency department visit or hospital admission within 90 days of surgery. Binary logistic regression was fit for discharge disposition, 30- and 90-day readmission, and 1 year revision while controlling for all significant covariates. We identified a total of 11,598 patients' status post-THA, of whom 273 had a PHE. PHE patients were significantly more likely to require facility discharge (odds ratio [OR]: 2.490; p < 0.001) than those who did not have a PHE. Additionally, any PHE predisposed patients to significantly higher 30-day (OR: 1.992; p = 0.013) and 90-day (OR: 2.387; p < 0.001) readmission rates. Patients with two or more PHEs were at an even greater risk of facility discharge (OR: 3.679; p = 0.001), readmission within 30 days (OR: 4.204; p = 0.009), and readmission within 90 days (OR: 7.965; p < 0.001). Patients who undergo THA after having a PHE are at significantly higher risk of facility discharge and readmission. A temporary recovery period and evaluation of surgical candidacy following a PHE and prior to THA may lead to better postoperative outcomes. Level III Evidence Retrospective Cohort Study