title: Two-Day Length of Stay is Not Inferior to 3 Days in Total Knee Arthroplasty with Regards to 30-Day Readmissions.
abstract: The impact of a shortened length of stay (LOS) following total knee arthroplasty (TKA) on the risk of readmission is not well documented despite recent trends towards shorter hospitalization. We retrospectively compared the adjusted risk of 30-day readmission following TKA between patients with 2-, 3- and 4-day LOS using current postoperative care protocols. A total of 23,655 consecutive primary, unilateral TKAs operated between 01/01/2009 and 12/31/2011 were studied retrospectively using non-inferiority testing. The main outcome was 30-day readmission. Two-day LOS decreased the odds of readmission by a factor of 0.96, with an upper bound one-sided 95% confidence interval of 1.10. After adjusting for other variables, LOS of 2 days is not inferior to 3 days with respect to the risk of 30-day readmission.
authors.affiliation: Department of Orthopaedic Surgery, The Permanente Medical Group, 280 Macarthur Blvd, Oakland, CA.
authors.forename: Stefano A
authors.initials: SA
authors.lastname: Bini
authors.affiliation: Surgical Outcomes and Analysis, Kaiser Permanente, 8954 Rio San Diego Drive, Suite 406, San Diego, CA.
authors.forename: Maria C S
authors.initials: MC
authors.lastname: Inacio
authors.affiliation: Surgical Outcomes and Analysis, Kaiser Permanente, 8954 Rio San Diego Drive, Suite 406, San Diego, CA.
authors.forename: Guy
authors.initials: G
authors.lastname: Cafri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: length of stay; non-inferiority; readmission; risk factors; total knee arthroplasty