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Predictive Risk Factors for 30-day Readmissions Following Primary Total Joint Arthroplasty and Modification of Patient Management
Authors:Samantha Tayne  Christian A. Merrill  Eric L. Smith  William C. Mackey
Affiliation:1. Tufts University School of Medicine, Boston MA;2. Department of Orthopaedic Surgery, Tufts Medical Center, Boston MA;3. Department of Surgery, Tufts Medical Center, Boston MA
Abstract:
The Centers for Medicare and Medicaid have begun to publically publish statistics on readmissions following primary total hip (THA) and total knee arthroplasty (TKA). Our study retrospectively assesses 30-day readmissions rates following THA and TKA, performed by a single surgeon at a tertiary care medical center between 2007 and 2012. Results of a univariate analysis and logistic regression model indicated female gender, high ASA class, and increased operative time to be significantly associated with higher rates of readmission (OR 4.646, OR 1.257, and OR 5.323, respectively). Readmissions most often occurred within the first week of patient discharge. Surgical complications and gastrointestinal discomfort were the most common causes for readmission. Using readmission risk we can stratify patients into tiered critical care pathways to reduce readmissions.
Keywords:readmission   30-day   primary total joint arthroplasty   risk factors   post-operative management
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