Incidence of and risk factors for 30-day readmission following elective primary total joint arthroplasty: Analysis from the ACS-NSQIP

Andrew J. Pugely, John J. Callaghan, Christopher T. Martin, Peter Cram, Yubo Gao

Research output: Contribution to journalArticlepeer-review

163 Scopus citations

Abstract

Recently, the government has moved towards public reporting of 30-day readmission rates after elective primary total knee (TKA) and total hip arthroplasty (THA). We identified 11,814 and 8105 patients who underwent primary TKA and THA from the 2011 ACS NSQIP. Overall readmission rates within 30-days of surgery were 4.6% for TKA and 4.2% for THA. Complications associated with readmission were predominantly wound infections, sepsis, thromboembolic, cardiac, and respiratory related. In TKA, multivariate analysis identified age (P= 0.002), male gender (P= 0.03), cancer history (P= 0.008), elevated BUN (P= 0.002), a bleeding disorder (P<. 0.001) and high ASA class (P<. 0.001) as predictors of readmission. In THA, obesity (P= 0.008), steroid use (P= 0.037), a bleeding disorder (P= 0.002), dependent functional status (P= 0.022), and high ASA class (P<. 0.001) predicted readmission. Understanding characteristics associated with readmission will be essential for equitable patient risk stratification.

Original languageEnglish (US)
Pages (from-to)1499-1504
Number of pages6
JournalJournal of Arthroplasty
Volume28
Issue number9
DOIs
StatePublished - Oct 2013

Keywords

  • 30-day
  • Arthroplasty
  • NSQIP
  • Readmission
  • Risk factors
  • THA
  • TKA

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