What Are the 30-day Readmission Rates Across Orthopaedic Subspecialties?

Bernatz, James T.; Tueting, Jonathan L.; Hetzel, Scott; Anderson, Paul A.

doi:10.1007/s11999-015-4602-5

Cited by 28 publications

(25 citation statements)

References 26 publications

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“…20 Moreover, 30-day readmissions for other specialties are significantly higher, with rates for internal medicine and general surgery reported at 12 to 14% and 11 to 12%, respectively. 32,33 The data presented here from our institution demonstrate a 90-day readmission rate of 4.86% (79/1,625), with a 3.2% (52/1,625) 30-day readmission rate following elective TKA. These are comparable with other studies reporting 4 to 9% 90-day readmission rates and a NSQIP database review suggesting 30-day readmission rates between 4 and 6%.…”

Section: Discussionmentioning

confidence: 72%

“…These are comparable with other studies reporting 4 to 9% 90-day readmission rates and a NSQIP database review suggesting 30-day readmission rates between 4 and 6%. 28,[33][34][35] Readmissions within 30 days are considered an important quality metric by CMS making it an appropriate target for surgeons and health care systems to evaluate. 33 Roughly two-thirds (52/79) of medical and orthopaedic readmissions in our study occurred within 30 days.…”

Section: Discussionmentioning

confidence: 99%

“…28,[33][34][35] Readmissions within 30 days are considered an important quality metric by CMS making it an appropriate target for surgeons and health care systems to evaluate. 33 Roughly two-thirds (52/79) of medical and orthopaedic readmissions in our study occurred within 30 days. We found 11/52 readmissions within 30 days to be secondary to orthopaedic causes including hematomas (3/11), falls (4/ 11), superficial or deep joint infections (3/11), or wound drainage (1/11), and none were deemed preventable based on the objective criteria presented above.…”

Section: Discussionmentioning

confidence: 99%

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Are Readmissions After Total Knee Arthroplasty Preventable?

Copp

Weinberg

et al. 2019

J Knee Surg

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Readmission within 90 days following total joint arthroplasty has become a central quality measure of reimbursement initiatives; however, the validity of readmission rates as a measure of hospital care quality and the proportion of readmissions that are preventable are unknown. The purpose of this study is to determine if readmissions within 30 and 90 days after total knee arthroplasty (TKA) were related to orthopaedic or medical etiology and identify if these readmissions were preventable. We retrospectively reviewed 1,625 elective TKAs performed between 2011 and 2014 at our institution. Readmissions within 30 and 90 days were categorized into orthopaedic and medical etiologies and an expert research panel determined if readmissions were potentially preventable based on objective criteria from national or peer-reviewed consensus guidelines. Out of the 1,625 TKAs performed during the study period, there were a total of 79 (4.8%) readmissions within 90 days of surgery, of which 17 (22%) were of orthopaedic etiology and 62 (78%) were of medical etiology. Fifty-two (66%) of the 79 readmissions occurred within 30 days, with 11 (21%) of orthopaedic and 41 (80%) of medical etiology. Only 2 of 79 (3%) readmissions within 90 days were deemed potentially preventable, and neither of them were orthopaedic in nature. Hospital readmissions after total joint arthroplasty are inevitable; however, only a small percentage (3%) of readmissions to our health care system was potentially preventable. Orthopaedic readmissions constituted a minority of the proportion of readmissions at 30 or 90 days, and none were deemed preventable.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Are Readmissions After Total Knee Arthroplasty Preventable?

Copp

Weinberg

et al. 2019

J Knee Surg

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“…The general orthopedic population is operatively diverse, encompassing everything from trauma to TJA and spine services. However, 30‐day readmission rates are relatively similar between the subspecialties, at approximately 3% to 6% for all‐cause readmissions 7‐11 . The most common reasons for readmission across the orthopedic patient population are infection, cardiopulmonary disease, and procedure/device complication 12‐14 .…”

Section: Introductionmentioning

confidence: 99%

“…The most common reasons for readmission across the orthopedic patient population are infection, cardiopulmonary disease, and procedure/device complication 12‐14 . Previous studies have identified increased American Society of Anesthesiologists (ASA) class, smoking, diabetes, insurance status, sex, Charlson Comorbidity Index (CCI) score, and extended length of stay (LOS) as being predictive of readmission risk 8,10,11,13 . These variables represent the large pool of patient data that can be leveraged for readmission prediction, but currently, there is no definitive tool to facilitate the integration of this array of risk factors.…”

Section: Introductionmentioning

confidence: 99%

Composite score for prediction of 30‐day orthopedic surgery outcomes

Caplan

Winter

Glauser

et al. 2020

Journal Orthopaedic Research

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The LACE+ (Length of stay, Acuity of admission, Charlson Comorbidity Index score, and Emergency department visits in the past 6 months) risk‐prediction tool has never been tested in an orthopedic surgery population. LACE+ may help physicians more effectively identify and support high‐risk orthopedics patients after hospital discharge. LACE+ scores were retrospectively calculated for all consecutive orthopedic surgery patients (n = 18 893) at a multi‐center health system over 3 years (2016‐2018). Coarsened exact matching was employed to create “matched” study groups with different LACE+ score quartiles (Q1, Q2, Q3, Q4). Outcomes were compared between quartiles. In all, 1444 patients were matched between Q1 and Q4 (n = 2888); 2079 patients between Q2 and Q4 (n = 4158); 3032 patients between Q3 and Q4 (n = 6064). Higher LACE+ scores significantly predicted 30D readmission risk for Q4 vs Q1 and Q4 vs Q3 (P < .001). Larger LACE+ scores also significantly predicted 30D risk of ED visits for Q4 vs Q1, Q4 vs Q2, and Q4 vs Q3 (P < .001). Increased LACE+ score also significantly predicted 30D risk of reoperation for Q4 vs Q1 (P = .018), Q4 vs Q2 (P < .001), and Q4 vs Q3 (P < .001).

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Investigating readmission rates for patients undergoing oncologic resection and endoprosthetic reconstruction for primary sarcomas and tumors involving bone

Lazarides

Flamant

Cullen

et al. 2022

Journal of Surgical Oncology

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Background: Little is known about the drivers of readmission in patients undergoing Orthopaedic oncologic resection. The goal of this study was to identify factors independently associated with 90-day readmission for patients undergoing oncologic resection and subsequent prosthetic reconstruction for primary tumors involving bone.Methods: This was a retrospective comparative cohort study of patients treated from 2008 to 2019 who underwent endoprosthetic reconstruction for a primary bone tumor or soft tissue tumor involving bone, as well as those who underwent a revision endoprosthetic reconstruction if the primary endoprosthetic reconstruction was performed for an oncologic resection. The primary outcome measure was unplanned 90-day readmission.Results: A total of 149 patients were identified who underwent 191 surgeries were for a primary bone or soft tissue tumor. The 90-day readmission rate was 28.3%. Female gender, depression, higher tumor grade, vascular reconstruction, longer procedure duration, longer length of stay (LOS), multiple surgeries during an admission and disposition to a Skilled Nursing Facility were associated with readmission (p < 0.05). In a multivariate analysis, female sex, higher tumor grade and longer procedure duration were independently associated with risk of readmission (p < 0.05).Conclusions: Readmission rates are high following endoprosthetic reconstruction for Orthopaedic oncologic resections. Further work is necessary to help minimize unplanned readmissions.

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What Are the 30-day Readmission Rates Across Orthopaedic Subspecialties?

Cited by 28 publications

References 26 publications

Are Readmissions After Total Knee Arthroplasty Preventable?

Are Readmissions After Total Knee Arthroplasty Preventable?

Composite score for prediction of 30‐day orthopedic surgery outcomes

Investigating readmission rates for patients undergoing oncologic resection and endoprosthetic reconstruction for primary sarcomas and tumors involving bone

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