Factors Associated With 30-Day Readmission After Primary Total Hip Arthroplasty

Ali, Adam M.; Loeffler, M.; Aylin, Paul; Bottle, Alex

doi:10.1001/jamasurg.2017.3949

Cited by 59 publications

(28 citation statements)

References 34 publications

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“…Gold et al 9 found patients with depression increased the odds of 90-day hospital readmissions in patients undergoing either primary total knee (OR: 1.21, 95%CI: 1.13-1.29, p < 0.001) or total hip (OR: 1.24, 95%CI: 1.13-1.35, p < 0.001) arthroplasty. These results are further supported by Ali et al 26 who assessed for patient-related risk factors for readmissions following primary total hip arthroplasty in 514,455 patients utilizing the United Kingdom National Health Service and found depression significantly increased the odds (OR: 1.52, 95%CI: 1.31-1.76, p < 0.001) of 30-day readmissions following primary total hip arthroplasty. In addition to longer LOS and higher odds of readmissions, our study demonstrated that patients who have depressive disorders had higher incidence and odds of medical and implant-related complications.…”

Section: Discussionsupporting

confidence: 59%

Impact of depressive disorders on primary total shoulder arthroplasties: a matched control analysis of 113,648 Medicare patients

et al. 2020

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Introduction The purpose of this study was to investigate whether patients with depressive disorders undergoing primary total shoulder arthroplasty have higher rates of (1) in-hospital lengths of stay, (2) readmission rates, (3) medical complications, and (4) implant-related complications. Methods A retrospective query was performed using a national claims database. Study group patients were matched to controls in a 1:5 ratio according to age, sex, and medical comorbidities. The query yielded 113,648 patients who were with (n = 18,953) and without (n = 94,695) depressive disorders. Pearson’s χ 2 analyses were used to compare patient demographics. Logistic regression analyses were used to calculate odds-ratios of complications and readmission rates. Welch’s t-tests were used to test for significance for in-hospital lengths of stay. A p-value less than 0.003 was considered statistically significant. Results Study group patients had significantly longer in-hospital lengths of stay (2.7 days versus 2.3 days; p < 0.0001). Patients who have depressive disorders had higher incidences and odds of readmissions (9.4 versus 6.15%; odds-ratio: 1.6, p < 0.0001), medical complications (2.7 versus 0.9%; odds-ratio: 3.0, p < 0.0001), and implant-related complications (6.1 versus 2.4%; odds-ratio: 2.59, p < 0.0001) compared to controls. Conclusion Depressive disorder patients have longer in-hospital lengths of stay and increased odds of readmissions and complications following primary total shoulder arthroplasty.

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Section: Discussionsupporting

confidence: 59%

Impact of depressive disorders on primary total shoulder arthroplasties: a matched control analysis of 113,648 Medicare patients

et al. 2020

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“…Ten studies (16 analyses) were suitable for meta-analysis [ 67 – 69 , 73 , 75 , 77 – 80 , 83 ]. These studies examined the impact of SMI on 30-day readmission rates specifically, except for one study that looked at 28-day readmission rates [ 75 ].…”

Section: Resultsmentioning

confidence: 99%

Severe mental illness and health service utilisation for nonpsychiatric medical disorders: A systematic review and meta-analysis

et al. 2020

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Background Psychiatric comorbidity is known to impact upon use of nonpsychiatric health services. The aim of this systematic review and meta-analysis was to assess the specific impact of severe mental illness (SMI) on the use of inpatient, emergency, and primary care services for nonpsychiatric medical disorders. Methods and findings PubMed, Web of Science, PsychINFO, EMBASE, and The Cochrane Library were searched for relevant studies up to October 2018. An updated search was carried out up to the end of February 2020. Studies were included if they assessed the impact of SMI on nonpsychiatric inpatient, emergency, and primary care service use in adults. Study designs eligible for review included observational cohort and case-control studies and randomised controlled trials. Random-effects meta-analyses of the effect of SMI on inpatient admissions, length of hospital stay, 30-day hospital readmission rates, and emergency department use were performed. This review protocol is registered in PROSPERO (CRD42019119516). Seventy-four studies were eligible for review. All were observational cohort or case-control studies carried out in high-income countries. Sample sizes ranged from 27 to 10,777,210. Study quality was assessed using the Newcastle-Ottawa Scale for observational studies. The majority of studies ( n = 45) were deemed to be of good quality. Narrative analysis showed that SMI led to increases in use of inpatient, emergency, and primary care services. Meta-analyses revealed that patients with SMI were more likely to be admitted as nonpsychiatric inpatients (pooled odds ratio [OR] = 1.84, 95% confidence interval [CI] 1.21–2.80, p = 0.005, I 2 = 100%), had hospital stays that were increased by 0.59 days (pooled standardised mean difference = 0.59 days, 95% CI 0.36–0.83, p < 0.001, I 2 = 100%), were more likely to be readmitted to hospital within 30 days (pooled OR = 1.37, 95% CI 1.28–1.47, p < 0.001, I 2 = 83%), and were more likely to attend the emergency department (pooled OR = 1.97, 95% CI 1.41–2.76, p < 0.001, I 2 = 99%) compared to patients without SMI. Study limitations include considerable heterogeneity across studies, meaning that results of meta-analyses should be interpreted with caution, and the fact that it was not always possible to determine whether service use outcomes definitively excluded mental health treatment. Conclusions In this study, we found that SMI impacts significantly upon the use of nonpsychiatric health services. Illustrating and quantifying this helps to build a case for and guide the delivery of system-wide integration of mental and physical health services.

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“…4,5 Many researchers attempting to identify risk factors for complications have focused on a singular adverse event, and only a few investigators have considered multiple complications within the same cohort. [6][7][8][9][10] In addition, it is often difficult to generalize the results of a study to different population groups owing to region-specific factors such as ethnic composition and socioeconomic differences among the populations. 11,12 The purpose of this study was to determine the risk factors for postoperative infection, revision and death 3 months and 1 year after primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) through the use of large administrative databases.…”

Section: Contextementioning

confidence: 99%

Risk factors for infection, revision, death, blood transfusion and longer hospital stay 3 months and 1 year after primary total hip or knee arthroplasty

Rhee

Lethbridge

Richardson

et al. 2018

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Factors Associated With 30-Day Readmission After Primary Total Hip Arthroplasty

Cited by 59 publications

References 34 publications

Impact of depressive disorders on primary total shoulder arthroplasties: a matched control analysis of 113,648 Medicare patients

Impact of depressive disorders on primary total shoulder arthroplasties: a matched control analysis of 113,648 Medicare patients

Severe mental illness and health service utilisation for nonpsychiatric medical disorders: A systematic review and meta-analysis

Risk factors for infection, revision, death, blood transfusion and longer hospital stay 3 months and 1 year after primary total hip or knee arthroplasty

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