Background: Postoperative length of stay (LOS) of 1 day compared with that of 2 to 4 days after primary total knee arthroplasty (TKA) or total hip arthroplasty (THA) and 90-day readmissions. Methods: PearlDiver identified TKA (n = 648,758) and THA patients (n = 346,732) between 2005 and 2014. Groups consisted of control (LOS = 1 day) and study (LOS = 2 to 4 days) groups. Study and control groups were matched to age, sex, and Elixhauser Comorbidity Index. Logistic regression analysis and odds ratio analyzed 90-day readmission rates. P , 0.05 was statistically significant. Results: TKA patients' LOS of 2 days (odds ratio [OR], 2.89; 95% confidence interval [CI], 2.77 to 3.00), LOS of 3 days (OR, 2.80; 95% CI, 2.69 to 2.91), and LOS of 4 days (OR, 2.83; 95% CI, 2.72 to 2.95) had greater 90-day readmission compared with LOS of 1 day (P , 0.05). THA patients with an LOS of 2 days (OR, 2.93; 95% CI, 2.77 to 3.10), an LOS of 3 days (OR, 2.91; 95% CI, 2.75 to 3.07), or an LOS of 4 days (OR, 2.91; 95% CI, 2.73 to 3.05) had greater 90-day readmission compared with an LOS of 1 day (P , 0.05). Conclusion: LOS .1 day has greater odds of 90-day readmission after an index procedure. Efficient progression to early discharge regarding patient-specific risk factors plays a large role in preventing readmission.
Recent efforts within total joint arthroplasty (TJA) have focused on reducing the episode of care costs without sacrificing quality of care and patient outcomes. 1-3 Minimizing postoperative readmission rates decreases overall costs and healthcare burden, as well as postprocedural morbidity, and has become a major surrogate for assessing surgical outcomes. [1][2][3] However, in efforts to identify those specific risk factors which may predispose to unplanned readmission, studies present conflicting evidence, particularly regarding the significance of in-hospital length of stay (LOS) after surgery.Mean hospital LOS decreased from 9.1 days to 3.7 days, whereas 30-day all-cause readmission rates increased from 5.9% to 8.5%; however, the