title: Predictors of readmission in orthopaedic trauma surgery.
abstract: OBJECTIVE
  This study of patients who had operative treatment of skeletal trauma addresses (1) the association between readmission within 30 days of discharge and comorbidities and (2) differences in factors associated with all-cause readmissions and those because of a surgical adverse event.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary care referral center.
  
  
  METHODS
  Three thousand four hundred fifty-two operations for skeletal trauma between 2008 and 2012 with comorbidities quantified using the updated Charlson comorbidity index (CCI).
  
  
  METHODS
  Readmission to the hospital within 30 days of surgery and the subset of readmissions because of adverse events related directly to surgery.
  
  
  RESULTS
  There was a significant association between readmission within 30 days of surgery and higher CCI (P < 0.001), older age (P < 0.001), and marital status (widowed) (P < 0.001). The factors associated with readmission related to an adverse event were identical. The best multivariable logistic regression models for all-cause 30-day readmission and 30-day readmission related to a surgical adverse event included CCI and older age in both models (odds ratio 1.1, P < 0.01, pseudo R = 0.03).
  
  
  CONCLUSIONS
  Older patients and patients with greater comorbidity are more likely to be readmitted within 30 days of surgery for musculoskeletal trauma, whether for a surgical adverse event or another reason. The best multivariable models predicted very little of the variability in readmission, which reflects the complexity of readmission and the difficulty reducing the risk to a few specific factors.
  
  
  METHODS
  Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Orthopaedic Department, Massachusetts General Hospital, Boston, MA.
authors.forename: Michiel G J S
authors.initials: MG
authors.lastname: Hageman
authors.forename: Jeroen K J
authors.initials: JK
authors.lastname: Bossen
authors.forename: R Malcolm
authors.initials: RM
authors.lastname: Smith
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D009141:Musculoskeletal System / Q000293:injuries* / Q000601:surgery; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult