Thirty-Day Readmission Rates Comparing Specific Cruciate Retaining and Posterior Stabilizing Knee Arthroplasties to the National Readmission Rates.

摘要

Unplanned hospital readmissions within 30 days of surgery result in reimbursement penalties following total knee arthroplasty (TKA). Therefore, evaluating current readmission rates and comparing these to national levels is one way to self-assess and determine possible areas where improvements can be made. In this study, the 30-day readmission data for 845 TKAs performed with a single prosthesis were compared to the readmission data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Database of 12,035 TKAs. We determined this following: (1) whether the TKA groups readmission rates were comparable; (2) the similarities and differences between readmission causes between the cohorts; and (3) the patient factors associated with increased readmission rates. The 30-day readmission rate for our cohort was lower than the NSQIP rate (2.1% versus 4.3%, respectively). Among all readmissions, our database had fewer readmissions due to surgically related complications (44% versus 57%, respectively). Patients in the single-prosthesis database had higher body mass indexes and higher rates of cardiovascular disorders, diabetes, and musculoskeletal disease. Within the NSQIP cohort, a higher proportion of males than females were readmitted. The most common comorbidities in the readmitted cohort were diabetes, chronic obstructive pulmonary disease, cardiac surgery, hypertension, bleeding disorders, and American Society of Anesthesiologists (ASA) grade 3. Of the surgically related factors, readmitted patients had significantly longer operative procedures. The 30-day readmission rate for patients undergoing primary TKAs in our database was lower than that of a national database.