Re-admission rates within 28 days of total hip replacement.
BACKGROUND
The aim of the study was to identify the reasons for the higher than expected emergency re-admission to hospital within 28 days of total hip replacement (THR) for Stepping Hill Hospital, Stockport.


METHODS
Over a 42-month period, 65 (8.5%) of 769 patients were re-admitted within 28 days of discharge following primary THR. Case notes for 61 patients were available for retrospective review to assess premorbidity, initial postoperative complications and reason for re-admission.


RESULTS
The main reasons for re-admission were complications related to the procedure. These included thrombo-embolic disease 2.5%, atraumatic dislocation 1.4%, wound complications 1.2% and swollen limb 1.8%. Other causes such as admission to another department for problems not related to THR accounted for 0.8%.


CONCLUSIONS
Our findings are comparable with the published literature for early complications following THR. The three main reasons for re-admission were atraumatic dislocation, thrombo-embolic and wound complications such as superficial infection and haematoma are the commonest world-wide. The re-admission rate to hospital within the first 28 days following THR was a clinical indicator suggested by the UK Department of Health. It has subsequently been incorporated in a group of indicators used by the CASPE Healthcare Knowledge Systems (CHKS), a private healthcare consultancy and analysis company, for peer benchmarking. Our re-admission rates are inflated by admissions for non-THR-related reasons. The level of post-THR complications leading to re-admission were acceptable compared with the available published literature regarding 28-day re-admission. We anticipate that this study may act as a benchmark for other trusts.
Cullen
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Department of Trauma and Orthopaedics, Stepping Hill Hospital, Stockport, UK. claremc@gmail.com
Johnson
D S
DS
Cook
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D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D004487:Edema / Q000209:etiology; D004630:Emergencies; D004739:England; D005260:Female; D006617:Hip Dislocation / Q000209:etiology; D006622:Hip Prosthesis; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013923:Thromboembolism / Q000209:etiology; D013997:Time Factors