Identifying Risk Factors for Complication and Readmission with Same-Day Discharge Arthroplasty

Abella, Maveric; Ezeanyika, Chukwunweike N; Finlay, Andrea K.; Amanatullah, Derek F.

doi:10.1016/j.arth.2022.12.036

Cited by 6 publications

(6 citation statements)

References 34 publications

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“…Tracking demand and incidence of medical procedures is important for ensuring adequate access to care throughout the community. Demand and interest in care can fluctuate based on geographic region, time, population, racial disparities, and current events [ 1 ]. Our investigation shows that correlations exist between Google Trends data and national databases like ACS NSQIP and CDC COVID-19 Tracker.…”

Section: Discussionmentioning

confidence: 99%

“…Knee replacement and hip replacement are colloquial terms for two common elective procedures, namely, total knee arthroplasty (TKA) and total hip arthroplasty (THA). Joint replacements were chosen because it is a highly known, elective procedure that was expected to decrease during the pandemic due to changes in physical activity and prior literature [ 1 ]. Appendicitis was searched as a control because it often results in an appendectomy, the most common emergent surgical procedure on ACS NSQIP whose case and search volume were expected to show minimal shift during the pandemic.…”

Section: Methodsmentioning

confidence: 99%

“…Large databases like the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and the Center for Disease Control (CDC) COVID tracker are useful for examining national caseloads and patient outcomes [ 1 ]. However, these large databases often lack more refined geographic and social information that could benefit medical case tracking.…”

Section: Introductionmentioning

confidence: 99%

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The Relationship Between Public Interest and Surgical Demand During the COVID-19 Pandemic

Abella¹,

Abella²,

Yoshida³

2023

Cureus

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Introduction: Surgical databases are useful for examining outcomes and case volume to improve care, while public interest data has the potential to track the supply and demand of medical services in specific communities. However, the relationship between public interest data and case volume from surgical databases, specifically during disruptive instances like the coronavirus pandemic, is unknown. Therefore, the purpose of this study is to determine how public interest data is related to the case volume of coronavirus and other surgical procedures performed during the coronavirus pandemic.Methods: This retrospective study included a review of appendectomy, total hip arthroplasty (THA), and total knee arthroplasty (TKA) cases from the National Surgery Quality Improvement Project and relative search volume (RSV) of hip replacement, knee replacement, appendicitis, and coronavirus from Google Trends from 2019 to 2020. T-tests were used to compare surgical caseload and RSV data before and after the COVID-19 surge in March 2020, while linear models were used to determine relationships between confirmed procedures and relative search volumes.Results: The RSV for knee replacement (p < 0.001, Cohen's D [d] = -5.01, 95% confidence interval [CI]: -7.64 to -2.34) and hip replacement (p < 0.001, d = -7.22, 95% CI: -10.85 to -3.57) had a large dip during the coronavirus pandemic, while the RSV for appendicitis had a smaller dip (p = 0.003, d = -2.37, 95% CI: -3.93 to -0.74). Linear models showed very strong linear relationships between surgical RSV and surgical volume for TKA (R 2 = 0.931) and THA (R 2 = 0.940).Conclusions: There was a significant reduction in the number of elective surgeries, which correlated to drops in public interest during COVID-19. The strong correlations between RSV, surgical volume, and coronavirus cases indicate that public interest can be used to track and predict surgical case volume. Our findings allow for greater insight into the use of public interest data to gauge surgical demand.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Relationship Between Public Interest and Surgical Demand During the COVID-19 Pandemic

Abella¹,

Abella²,

Yoshida³

2023

Cureus

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“…The comorbidity package in R was used to identify the presence of Elixhauser comorbidities and calculate the Elixhauser comorbidity score with van Walraven weights . Of the comorbidities available, we report those that are included in the American College of Surgeons National Surgical Quality Improvement Program Risk Calculator and those that have been previously shown to be associated with readmission after knee arthroplasty …”

Section: Methodsmentioning

confidence: 99%

“…16 Of the comorbidities available, we report those that are included in the American College of Surgeons National Surgical Quality Improvement Program Risk Calculator 17 and those that have been previously shown to be associated with readmission after knee arthroplasty. [18][19][20][21]…”

Section: The Sasd Does Not Report Medical Comorbidities and The Ambul...mentioning

confidence: 99%

Freestanding Ambulatory Surgery Centers and Patients Undergoing Outpatient Knee Arthroplasty

2023

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ImportanceIn 2018, Medicare removed total knee arthroplasty from the list of inpatient-only procedures, resulting in a new pool of patients eligible for outpatient total knee arthroplasty. How this change was associated with the characteristics of patients undergoing outpatient knee arthroplasty at hospital-owned surgery centers (HOSCs) vs freestanding ambulatory surgery centers (FASCs) is unknown.ObjectivesTo describe the characteristics of patients undergoing outpatient, elective total and partial knee arthroplasty in 2017 and 2018 and to compare the cohorts receiving treatment at FASCs and HOSCs.Design, Setting, and ParticipantsThis observational retrospective cohort study included 5657 patients having elective, outpatient partial and total knee arthroplasty in the Florida and Wisconsin State Ambulatory Surgery Databases in 2017 and 2018. Prior admissions were identified in the State Inpatient Database. Statistical analysis was performed from March to June 2022.Main Outcomes and MeasuresCharacteristics of patients undergoing surgery at a FASC vs a HOSC in 2017 and 2018 were compared.ResultsA total of 5657 patients (mean [SD] age, 64.2 [9.9] years; 2907 women [51.4%]) were included in the study. Outpatient knee arthroplasties increased from 1910 in 2017 to 3747 in 2018 and were associated with an increase in total knee arthroplasties (474 in 2017 vs 2065 in 2018). The influx of patients undergoing outpatient knee arthroplasty was associated with an amplification of differences between the patients treated at FASCs and the patients treated at HOSCs. Patients with private payer insurance seen at FASCs increased from 63.4% in 2017 (550 of 867) to 72.7% in 2018 (1272 of 1749) (P &lt; .001), while the percentage of patients with private payer insurance seen at HOSCs increased, but to a lesser extent (41.6% [427 of 1027] in 2017 vs 46.4% [625 of 1346] in 2018; P &lt; .001). In 2017, the percentages of White patients seen at FASCs and HOSCs were similar (85.0% [737 of 867] vs 88.2% [906 of 1027], respectively); in 2018, the percentage of White patients seen at FASCs had increased and was significantly different from the percentage of White patients seen at HOSCs (90.6% [1585 of 1749] vs 87.9% [1183 of 1346]; P = .01). Both types of facilities saw an increase from 2017 to 2018 in the percentage of patients from communities of low social vulnerability, but this increase was greater for FASCs (FASCs: 6.7% [58 of 867] in 2017 vs 33.9% [593 of 1749] in 2018; HOSCs: 7.6% [78 of 1027] in 2017 vs 21.2% [285 of 1346] in 2018). Finally, while FASCs and HOSCs had cared for a similar portion of patients with prior admissions in 2017 (7.8% [68 of 867] vs 9.4% [97 of 1027], respectively; P = .25), in 2018, FASCs cared for fewer patients with prior admissions than HOSCs (4.0% [70 of 1749] vs 8.1% [109 of 1346]; P &lt; .001).ConclusionsThis study suggests that the increase in the number of patients undergoing outpatient knee arthroplasty in 2018 corresponded to FASCs treating a greater share of patients who were White, covered by private payer insurance, and healthier. These findings raise a concern that as more operations transition to the outpatient setting, variability in access to FASCs may increase, leaving hospital-owned centers to bear a greater share of the burden of caring for more vulnerable patients with more severe illness.

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Emergency Department Visit Rates After Ambulatory Surgery

Rajasingh,

Wren

2024

JAMA Surg

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Identifying Risk Factors for Complication and Readmission with Same-Day Discharge Arthroplasty

Cited by 6 publications

References 34 publications

The Relationship Between Public Interest and Surgical Demand During the COVID-19 Pandemic

The Relationship Between Public Interest and Surgical Demand During the COVID-19 Pandemic

Freestanding Ambulatory Surgery Centers and Patients Undergoing Outpatient Knee Arthroplasty

Emergency Department Visit Rates After Ambulatory Surgery

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