Thirty-Day Readmission Following Total Hip and Knee Arthroplasty – A Preliminary Single Institution Predictive Model |
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Authors: | Nathan W Mesko Keith R Bachmann David Kovacevic Mary E LoGrasso Colin O’Rourke Mark I Froimson |
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Institution: | 1. Department of Orthopaedic surgery, Vanderbilt University Medical Center;2. Department of Orthopaedic Surgery Cleveland Clinic, Adult Reconstruction Section, Cleveland Clinic, Ohio;3. Lerner Research Institute, Cleveland, Ohio |
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Abstract: | We sought to identify demographic or care process variables associated with increased 30-day readmission within the total hip and knee arthroplasty patient population. Using this information, we generated a model to predict 30-day readmission risk following total hip and knee arthroplasty procedures. Longer index length of stay, discharge disposition to a nursing facility, blood transfusion, general anesthesia, anemia, anticoagulation status prior to index admission, and Charlson Comorbidity Index greater than 2 were identified as independent risk factors for readmission. Care process factors during the hospital stay appear to have a large predictive value for 30-day readmission. Specific comorbidities and patient demographic factors showed less significance. The predictive nomogram constructed for primary total joint readmission had a bootstrap-corrected concordance statistic of 0.76. |
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Keywords: | 30-day readmission value-based healthcare total joint arthroplasty risk stratification |
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