title: Are there identifiable risk factors and causes associated with unplanned readmissions following total knee arthroplasty?
abstract: We conducted a retrospective review of 3218 primary total knee arthroplasties (TKA) performed over two years at an urban academic hospital network using clinical and administrative data. Increased length of stay (LOS) was associated with readmission (P < 0.001). Readmission was not associated with age (P = 0.100), gender (P = 0.608), body mass index (P = 0.329), or staged bilateral procedures (P = 0.420). The most common readmitting diagnoses were post-operative infection (22.5%), hematoma (10.1%), pulmonary embolus (7.9%) and deep vein thrombosis (5.6%). Of readmissions, 53.9% were for surgical reasons and 46.1% were for medical reasons. Certain interventions described in previous literature may be more successful in minimizing unplanned readmissions by focusing on patients with extended LOS, elevated infection risk and low socioeconomic status.
authors: Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Michael M
authors: MM
authors: Kheir
authors: UNC School of Medicine, Chapel Hill, North Carolina.
authors: R Carter
authors: RC
authors: Clement
authors: Hospital for Special Surgery, New York, New York.
authors: Peter B
authors: PB
authors: Derman
authors: Department of Anesthesiology & Critical Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
authors: David N
authors: DN
authors: Flynn
authors: Department of Anesthesiology & Critical Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
authors: Rebecca M
authors: RM
authors: Speck
authors: Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors: L Scott
authors: LS
authors: Levin
authors: Department of Anesthesiology & Critical Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
authors: Lee A
authors: LA
authors: Fleisher
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: causes; interventions; readmitting diagnosis; risk factors; total knee arthroplasty; unplanned readmissions