Unplanned readmissions after primary total knee arthroplasty in Korean patients: Rate, causes, and risk factors

Lee, Seon-Woo; Gn, Kiran Kumar; Kim, Tae Kyun

doi:10.1016/j.knee.2016.05.011

Cited by 10 publications

(4 citation statements)

References 35 publications

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“…Of the total, 22 of 29, or 76%, were built in the United States [11,21,23e29,32e34,36e43]. Three models were built in Australia [22], and one each in China [30], Finland [35], Korea [31], and the United Kingdom [10]. One model was based on the prospective design [25], and the remaining (97%) were retrospective designs with 2 models applying additional case control [39,40].…”

Section: Resultsmentioning

confidence: 99%

“…Most models focused on 30-day readmission (17 of 29, or 59%) [10,11,21,23,26,27,29,30,32e34,36,38,40e42]. Nine models (31%) [22e25, 35,39,43] used 90-day readmission as an outcome measure, whereas 3 models (10%) [28,31,37] used both 30-day and 90day outcome measures for readmissions. The cohort-specific empirical readmission rates varied across the studies, and 2 studies, one with 3 models [22] and the other with one model [40], did not report readmission rates in their cohorts.…”

Section: Resultsmentioning

confidence: 99%

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Risk Factors for Readmission After Knee Arthroplasty Based on Predictive Models: A Systematic Review

et al. 2020

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Background: An increase in the aging yet active US population will continue to make total knee arthroplasty (TKA) procedures routine in the coming decades. For such joint procedures, the Centers for Medicare and Medicaid Services introduced programs such as the Comprehensive Care for Joint Replacement to emphasize accountable and efficient transitions of care. Accordingly, many studies have proposed models using risk factors for predicting readmissions after the procedure. We performed a systematic review of TKA literature to identify such models and risk factors therein using a reliable appraisal tool for their quality assessment. Methods: Five databases were searched to identify studies that examined correlations between post-TKA readmission and risk factors using multivariate models. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology and Transparent Reporting of a multivariate prediction model for Individual Prognosis Or Diagnosis criteria established for quality assessment of prognostic studies. Results: Of 29 models in the final selection, 6 models reported performance using a C-statistic, ranging from 0.51 to 0.76, and 2 studies used a validation cohort for assessment. The average 30-day and 90-day readmission rates across the studies were 5.33% and 7.12%, respectively. Three new significant risk factors were discovered. Conclusions: Current models for TKA readmissions lack in performance measurement and reporting when assessed with established criteria. In addition to using new techniques for better performance, work is needed to build models that follow the systematic process of calibration, external validation, and reporting for pursuing their deployment in clinical settings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Risk Factors for Readmission After Knee Arthroplasty Based on Predictive Models: A Systematic Review

et al. 2020

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“…PJI, a devastating complication associated with increased morbidity and mortality, necessitates subsequent multiple operations and requires substantial health-care funds [ 28 ]. And wound complications are the predominant causes of readmission in Asian population [ 29 ]. Wound problems can result in disastrous consequence and how to achieve effective wound healing in TJA is essential to improve satisfaction levels.…”

Section: Discussionmentioning

confidence: 99%

The effect of preoperative different dexamethasone regimens on postoperative glycemic control in patients with type 2 diabetes mellitus undergoing total joint arthroplasty: a retrospective cohort study

Mou,

Zhao,

Cai

et al. 2024

J Orthop Surg Res

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Background Concerns have been raised regarding the impact of preoperative intravenous dexamethasone on postoperative glycemic control in diabetic patients undergoing total joint arthroplasty (TJA). This study aimed to determine relationships between preoperative different dexamethasone regimens and postoperative fasting blood glucose (FBG), as well as to identify risk factors for postoperative FBG ≥ 200 mg/dl in diabetic patients undergoing TJA. Methods This retrospective study included 1216 diabetic patients undergoing TJA and categorized into group A (dexamethasone = 0 mg), group B (dexamethasone = 5 mg), and group C (dexamethasone = 10 mg). All dexamethasone was administered before skin incision. FBG levels were monitored until postoperative day (POD) 3. Analyses were conducted for periprosthetic joint infection (PJI) and wound complications during 90 days postoperatively. And the risk factors for postoperative FBG ≥ 200 mg/dl were identified. Results Preoperative dexamethasone administration resulted in a transiently higher FBG on POD 0 and POD 1 (all P < 0.001). However, no differences were observed on POD 2 (P = 0.583) and POD 3 (P = 0.131) among three groups. While preoperative dexamethasone led to an increase in postoperative mean FBG and postoperative maximum FBG (all P < 0.001), no differences were found in wound complications (P = 0.548) and PJI (P = 1.000). Increased HbA1c and preoperative high FBG, but not preoperative dexamethasone, were identified as risk factors for postoperative FBG ≥ 200 mg/dl. Preoperative HbA1c level of ≥ 7.15% was associated with an elevated risk of postoperative FBG ≥ 200 mg/dl. Conclusions Although preoperative intravenous administration of 5 mg or 10 mg dexamethasone in diabetic patients showed transient effects on postoperative FBG after TJA, no differences were found in the rates of PJI and wound complications during 90 days postoperatively. Notably, patients with a preoperative HbA1c level of ≥ 7.15% and elevated preoperative FBG may encountered postoperative FBG ≥ 200 mg/dl.

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“…For example, even the smallest femoral intramedullary nail is sometimes too big for insertion in Asian women. Additionally, there is an increased focus on unplanned readmissions after joint replacement in North America, and this research can guide best practices and improve health economics, but little information is available on this topic in Asian countries [9]. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR 1 or The Association of Bone and Joint Surgeons 1 .…”

mentioning

confidence: 99%

Unplanned readmissions after primary total knee arthroplasty in Korean patients: Rate, causes, and risk factors

Cited by 10 publications

References 35 publications

Risk Factors for Readmission After Knee Arthroplasty Based on Predictive Models: A Systematic Review

Risk Factors for Readmission After Knee Arthroplasty Based on Predictive Models: A Systematic Review

The effect of preoperative different dexamethasone regimens on postoperative glycemic control in patients with type 2 diabetes mellitus undergoing total joint arthroplasty: a retrospective cohort study

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