Patient and Perioperative Variables Affecting 30-Day Readmission for Surgical Complications After Hip and Knee Arthroplasties: A Matched Cohort Study

Ricciardi, Benjamin F.; Oi, Kathryn K.; Daines, Steven B.; Lee, Yuo-yu; Joseph, Amethia; Westrich, Geoffrey H.

doi:10.1016/j.arth.2016.10.019

Cited by 75 publications

(57 citation statements)

References 23 publications

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“…These include surgeon volume, operative time, general anesthesia, use of anticoagulation other than aspirin, increased length of hospital stay, and discharge to an inpatient rehabilitation facility [43][44][45][46][47]. Kurtz et al [44] found that increased surgeon volume has a protective effect against readmissions after TJA.…”

Section: Perioperative Risks For Readmissionmentioning

confidence: 99%

“…Increased operative time has also been shown to increase the rate of readmission. A study by Ricciardi et al [43] found that patients readmitted after THA and TKA had on average 9 min of increased operative time (84.4 ± 24.6 vs 75.0 ± 15.0 min) when compared to patients who were not readmitted. It is likely that surgeon Fig.…”

Section: Perioperative Risks For Readmissionmentioning

confidence: 99%

“…This supports the practice of using spinal anesthesia. One study also showed that the use of anticoagulation other than aspirin is a risk factor for readmission [43]. It is likely that the choice of anticoagulation is related to the comorbidities of the patient.…”

Section: Perioperative Risks For Readmissionmentioning

confidence: 99%

“…This may be partially due to the fact that increased hospital length of stay can increase the risk of hospital-acquired infections and thromboembolic events. Lastly, multiple studies have shown that discharge to inpatient facilities is associated with worse outcomes and increased rates of readmission [43][44][45][46][47]. A study by Fu et al [47] showed that discharge to inpatient facilities is independently associated with a higher rate of readmission and increased risk for a number of postdischarge complications.…”

Section: Perioperative Risks For Readmissionmentioning

confidence: 99%

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Improving Quality and Decreasing Cost by Reducing Re-admissions in Patients Undergoing Total Joint Arthroplasty

Sveom¹,

Otteman²,

Garvin³

2017

Curr Rev Musculoskelet Med

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Purpose of review Total joint arthroplasty (TJA) has had an increased demand over the recent years. It is a successful procedure, and there are relatively few complications, but there is a high overall cost. There is a push to increase the quality of care, lessen complications, and decrease cost by reducing readmissions. This article will discuss the risk factors that can contribute to the complication and readmission rates following TJA. Recent findings Several risk factors have been found to contribute to the complication and readmission rates following a TJA. It is important to understand these risk factors and mitigate them as much as possible in order to optimize the patient experience. There are risk factors that cannot be modified, and the treatment team as well as the patient should be made aware of these and account for them when making the decision whether to undergo elective primary TJA or not. In general, an increased number of risk factors is associated with increased complications and increased readmission rates. At our institution, we have used this knowledge to improve our outcomes and decrease costs. Summary It is important to be mindful of risk factors for poor outcomes prior to performing TJA. This allows for the optimization of patients prior to undergoing surgery. This can lead to improved outcomes at a lower cost.

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Section: Perioperative Risks For Readmissionmentioning

confidence: 99%

Section: Perioperative Risks For Readmissionmentioning

confidence: 99%

Section: Perioperative Risks For Readmissionmentioning

confidence: 99%

Section: Perioperative Risks For Readmissionmentioning

confidence: 99%

See 2 more Smart Citations

Improving Quality and Decreasing Cost by Reducing Re-admissions in Patients Undergoing Total Joint Arthroplasty

Sveom¹,

Otteman²,

Garvin³

2017

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

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“…Diagnoses of anxiety and depression have significant implications for the ability of IBD patients to make a successful postoperative recovery. Literature from other surgical subspecialities has demonstrated that anxiety and depression are risk factors for worse postoperative outcomes such as increased rates of immunosuppression, wound infection, cognitive dysfunction, longer length of stay and increased rates of hospital readmission . Patients with anxiety and depression require more postoperative narcotics and have higher rates of chronic pain after surgery .…”

Section: Discussionmentioning

confidence: 99%

Surgery, stomas, and anxiety and depression in inflammatory bowel disease: a retrospective cohort analysis of privately insured patients

et al. 2019

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Aim Patients with inflammatory bowel disease (IBD) are diagnosed with anxiety/depression at higher rates than the general population. We aimed to determine the frequency of anxiety/depression among IBD patients and the temporal association with abdominal surgery and stoma formation. MethodWe conducted a retrospective cohort study in adult patients with IBD using difference-in-difference methodology and a large commercial claims database (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016). Outcomes were anxiety/depression diagnoses before and after major abdominal surgery or stoma formation. ResultsWe identified 10 481 IBD patients who underwent major abdominal surgery, 18.8% of whom underwent stoma formation, and 41 924 nonsurgical age-and sexmatched IBD controls who were assigned random index dates. Rates of anxiety and depression increased among all cohorts (P < 0.001). Surgical patients had higher odds of anxiety [one surgery, adjusted OR 6.90 (95% CI 6.11-7.79), P < 0.001; two or more surgeries, 7.53 (5.99-9.46), P < 0.001] and depression [one surgery, 6.15 (5.57-6.80), P < 0.001; two or more surgeries, 6.88 (5.66-8.36), P < 0.001] than nonsurgical controls. Undergoing multiple surgeries was associated with a significant increase in depression from 'pre' to 'post' time periods [1.43 (1.18-1.73), P < 0.001]. Amongst surgical patients, stoma formation was independently associated with anxiety [1.40 (1.17-1.68), P < 0.001] and depression [1.23 (1.05-1.45), P = 0.01]. New ostomates experienced a greater increase in postoperative anxiety [1.24 (1.05-1.47), P = 0.01] and depression [1.19 (1.03-1.45), P = 0.01] than other surgical patients.Conclusion IBD patients who undergo surgery have higher rates of anxiety and depression than nonsurgical patients. Rates of anxiety and depression increase following surgery. Stoma formation represents an additional risk factor. These findings suggest the need for perioperative psychosocial support services. Keywords Stomas, depression, anxiety, inflammatory bowel diseaseWhat does this paper add to the literature? The relationship between surgery for inflammatory bowel disease, stoma formation, and anxiety and depression has been poorly quantified. We found that surgery for inflammatory bowel disease increased rates of anxiety and depression. Multiple surgeries and stoma-forming surgeries placed patients at additional risk. This suggests the need for additional psychosocial support services for these high-risk patients.

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

et al. 2017

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Patient and Perioperative Variables Affecting 30-Day Readmission for Surgical Complications After Hip and Knee Arthroplasties: A Matched Cohort Study

Cited by 75 publications

References 23 publications

Improving Quality and Decreasing Cost by Reducing Re-admissions in Patients Undergoing Total Joint Arthroplasty

Improving Quality and Decreasing Cost by Reducing Re-admissions in Patients Undergoing Total Joint Arthroplasty

Surgery, stomas, and anxiety and depression in inflammatory bowel disease: a retrospective cohort analysis of privately insured patients

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

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