Incidence, Risk Factors, and Costs for Hospital Returns After Total Joint Arthroplasties

Preoperative Emergency Department Visits Are Predictive of 90-Day Postoperative Emergency Department Visits and Discharge Disposition in Total Knee Arthroplasty Patients

“…Several papers have reported high rates of return to the ED, with rates ranging from 5 to 22% following an elective TKA procedure. 9,12,14 However, no recent paper has published findings demonstrating preoperative ED visits as predictive of postoperative visits with higher OR than known risk factors such as a diagnosis of diabetes. Interestingly, there have been no specific cost analysis studies published that examine how ED visits and ED visits leading to readmission will ultimately affect total cost to the hospitals and perception of quality following a TKA; however, calculated costs based on models are high, 9 and should be an area of further study.…”

“…9,12,14 However, no recent paper has published findings demonstrating preoperative ED visits as predictive of postoperative visits with higher OR than known risk factors such as a diagnosis of diabetes. Interestingly, there have been no specific cost analysis studies published that examine how ED visits and ED visits leading to readmission will ultimately affect total cost to the hospitals and perception of quality following a TKA; however, calculated costs based on models are high, 9 and should be an area of further study. In a recent study, Kelly et al found that in the 90-day period following TKA, there was an even distribution of medical and surgical reasons leading to ED visits and readmission in the first 30 days following TKA, followed by a gradual shift toward more medical reasons in the ensuing 60 days.…”

Are Readmissions After THA Preventable?

“…Medical records were reviewed by the research panel and included evaluation of operative reports, physician notes, inpatient vital signs, laboratory values, radiographic imaging, medications, and medical history. We defined a readmission as any unplanned inpatient or observation status admission to the hospital spanning at least one midnight [55]. To determine how readmissions were related to the timing of surgery, readmissions were categorized as 30-or 90-day readmissions based on the timing of readmission and were determined to be of orthopaedic or medical etiology [35].…”

CORR Insights®: Are Readmissions After THA Preventable?

“…Numerous studies [9,11,13,14] have reported on the predictors of, and complications associated with, post-THA readmissions. Mednick and colleagues [9] evaluated more than 9000 patients who underwent primary THA and reported a readmission rate within 30 days of just under 4%.…”

“…Sibia and colleagues [11] found a 5% rate of unplanned emergency room visits, with the most common complaints being pain/swelling (36%) and medication-related side effects (22%). They further reported a 30-day readmission rate of 3%, with ileus (23%) and wound infection (18%) as the two most-common reasons for readmission.…”