Identifying Risk Factors for 30-Day Readmissions After Triple Arthrodesis Surgery

Merrill, Robert; Ferrandino, Rocco; Hoffman, Ryan; Ndu, Anthony; Shaffer, Gene W.

doi:10.1053/j.jfas.2018.08.025

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…When treatment is initiated later in life, a salvage procedure, such as a naviulectomy, triple arthrodesis or talectomy, has often been required [6,32,33]. However, various complications have been associated with these procedures including wound breakdown, nonunion, and early arthritis of the involved joints [34][35][36]. Consequently, some surgeons have more recently advocated for correcting neglected CVT deformity with navicular or talar excisions.…”

Section: Discussionmentioning

confidence: 99%

Untreated congenital vertical talus deformity in walking age: minimally invasive method works

Cummings

Hosseinzadeh

2023

Journal of Pediatric Orthopaedics B

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There is sparse literature evaluating the outcomes in toddlers with congenital vertical talus (CVT) deformity who undergo treatment with the recently introduced minimally invasive Dobbs Method. We present the first study of this patient cohort to determine the efficacy of this method in patients 18 months of age and older. A list of all patients over 18 months of age who underwent CVT correction at our institution was created. Retrospective chart review was performed, and all follow-up notes were reviewed for clinical outcomes and complications. Eligible patients completed Patient-Reported Outcome Measurement Information System (PROMIS) questionnaires. Statistical analysis was performed using an alpha of 0.05. Sixteen children (24 feet) met all inclusion criteria and were included in the final analysis. Initial radiographic correction of all measured angles was seen, but by the latest follow-up, the average lateral TAMBA had increased from 12.04 degrees immediately postoperatively to 28.8 degrees at the latest follow-up (P = 0.0012). Radiographic recurrence of deformity was seen in 9 (37.5%) feet and additional unplanned surgery was required in 3 (12.5%) feet. Residual radiographic pes planus was seen in 5 (20.8%) feet. PROMIS pain interference and peer relationship scores were near the population mean. Although the recurrence rate in this patient population seems to be higher than that of younger patients, the majority of toddlers who undergo treatment with this method do experience successful outcomes. We recommend attempting this treatment method in toddlers before performing extensive soft tissue releases or salvage procedures.

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Section: Discussionmentioning

confidence: 99%

Untreated congenital vertical talus deformity in walking age: minimally invasive method works

Cummings

Hosseinzadeh

2023

Journal of Pediatric Orthopaedics B

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“…Die Komplikationen nach Arthrodese sind vielfältig und reichen von einer Fehlstellung der verschiedenen Gelenke oder des Gesamtfußes, Verletzung von Nerven oder Gefäßen, einer Mal- oder Nonunion der Gelenke bis hin zur Osteomyelitis. Merrill et al beschrieben nach Aufarbeitung der US-amerikanischen Nationwide Readmissions Database (NRD) eine 30-Tages-Wiederaufnahmerate von 4,6% nach Triple-Arthrodese, vor allem aufgrund von Wundkomplikationen und Infektionen 62 . Mäenpää et al berichten von einer schmerzfreien Fusionsrate von 93% bei 307 Triple-Arthrodesen.…”

Section: Chirurgische Therapie Der Rigiden Fehlstellungunclassified

Erworbener Plattfuß: Diagnose und chirurgische Behandlung

Döring¹,

Vertesich²,

Puchner³

2021

Z Orthop Unfall

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ZusammenfassungDer erworbene Plattfuß des Erwachsenen präsentiert sich als langsam progrediente Deformität, die unbehandelt zu quälenden Schmerzen und Einschränkungen der Aktivitäten des täglichen Lebens führen kann. Die Therapiemaßnahmen sind vielfältig und abhängig von klinischer und radiologischer Präsentation, sodass für jeden Patienten eine individuelle Versorgung geplant werden muss. Dieser Beitrag spannt einen Bogen von der Ätiopathogenese über die chirurgische Therapie bis hin zur postoperativen Mobilisierung und Rehabilitation.

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“…[ 4 – 6 ] Several other independent studies evaluated admissions based on specific disease states or surgeries such as heart failure, sepsis, chronic obstructive lung disease, heart valve surgery, and spine surgery. [ 7 – 11 ] However, relatively few studies have assessed whether or not traits of the physicians caring for the patients influence readmission rates as well. The current study attempts to address this literature gap.…”

Section: Introductionmentioning

confidence: 99%

Physician characteristics correlate with hospital readmission rates

Skolka

Lehman²,

Khalid

et al. 2020

Medicine

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Hospital readmission rates are used as a metric to measure quality patient care. While several tools predict readmissions based on patient-specific characteristics, this study assesses if physician characteristics correlate with hospital readmission rates. In a 5-year retrospective electronic record review at a single institution, 31 internal medicine attending physicians’ discharges were tracked for a total of 70 physician years, and 15,933 hospital discharges. Each physician's yearly 7-day, 8 to 30-day, and 30-day readmission rates were compared. Each rate was also correlated with years of post-graduate clinical experience, discharge volume, physician sex, and fiscal year. Individual physicians had significantly different 7-day, 8 to 30-day, and 30-day readmission rates from each other. The rates were not related to sex, years after post-graduate training, or fiscal year. However, physician patient volume correlated with 7-day readmission rates. Physicians who discharged ≤100 patients per year had a higher 7-day readmission rate than physicians who discharged >100 patients per year. This correlation with patient volume did not hold for the 8 to 30-day and 30-day readmission rates. Individual physicians differ in their patient readmission rates in 7-day, 8 to 30-day, and 30-day categories. A critical level of a physician's hospital activity, as reflected by the number of patient discharges per year (>100), results in lower 7-day readmission rates. Sex, post-graduate years of clinical experience, and fiscal year did not play a role. The lack of correlation between each physicians’ 7-day and 8 to 30-day readmission rates suggests that different physician factors are involved in these 2 rates.

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Identifying Risk Factors for 30-Day Readmissions After Triple Arthrodesis Surgery

Cited by 6 publications

References 35 publications

Untreated congenital vertical talus deformity in walking age: minimally invasive method works

Untreated congenital vertical talus deformity in walking age: minimally invasive method works

Erworbener Plattfuß: Diagnose und chirurgische Behandlung

Physician characteristics correlate with hospital readmission rates

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