Thirty-day readmission rate and discharge status following total hip arthroplasty using the supercapsular percutaneously-assisted total hip surgical technique.
OBJECTIVE
Recent studies have reported nearly 40% of costs associated with a 30-day episode-of-care for total joint replacements are due to post-discharge activities and 81% of those are specifically due to unplanned readmissions and discharging patients to post-acute care facilities. The purpose of this study was to determine these two key variables for total hip arthroplasty (THA) patients implanted using a tissue-sparing surgical technique and to see how these values compare to those previously reported in the United States.


METHODS
The healthcare databases at three institutions were searched for primary THA patients implanted using the supercapsular percutaneously-assisted total hip (SuperPath) surgical technique between January 2013 and July 2014. Data elements included 30-day all-cause readmission rate, discharge status, transfusion rate, complications, and length of stay (LOS).


RESULTS
Data were available for 479 THAs. The 30-day all-cause readmission rate, transfusion rate, and average LOS was 2.3, 3.3%, and 1.6 days, respectively. Over 91% of patients were discharged routinely home, 4.1% to skilled nursing facilities, 3.8% to home health care, and 0.6% to inpatient rehabilitation facilities. Complications included dislocation (0.8%), periprosthetic fracture (0.8%), and deep vein thrombosis (0.2 %). There were no infections reported.


CONCLUSIONS
Patients implanted using this tissue-sparing technique experienced reduced 30-day all-cause readmission rates (2.3% vs. 4.2%) and more were routinely discharged home (91.5% vs. 27.3%) than have been previously reported for patients in the United States. Use of this tissue-sparing technique has the potential to significantly reduce post-discharge costs.
Ottawa Hospital - Civic Campus, J153-1053 Carling Ave., Ottawa, ON, K1Y4E9, Canada.
Wade
W
Gofton
James
J
Chow
K Dean
KD
Olsen
David A
DA
Fitch
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States