title: Hospital Acquired Conditions Are the Strongest Predictor for Early Readmission: An Analysis of 26,710 Arthroplasties.
abstract: Hospital readmission is a metric of hospital quality of care, yet little is known what factors predict hospital readmission following arthroplasty. Our aim was to identify variables associated with early readmission following knee and hip arthroplasty, with focus upon hospital acquired conditions (HACs). Retrospective cohort analysis using Surgical Care Improvement Project (SCIP) and Veteran's Affairs Surgical Quality Improvement Program (VASQIP) data was performed over a five-year period. Following 26,710 total and partial primary arthroplasties (16,808 knees and 9902 hips), the overall 30-day readmission was 7.3% (1940) with readmission rates of 6.6% for knee arthroplasty and 8.4% for hip arthroplasty. HACs accounted for 42% of all complications and were the strongest predictor of readmission. Efforts to reduce these events may improve cost and safety of arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri; University of Alabama at Birmingham, School of Medicine.
authors.forename: Benjamin Todd
authors.initials: BT
authors.lastname: Raines
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Ponce
authors.affiliation: Center for Surgical Medical Acute Care Research and Transitions, Birmingham Veterans Affairs Medical Center; Department of Surgery, University of Alabama at Birmingham.
authors.forename: Rhiannon D
authors.initials: RD
authors.lastname: Reed
authors.affiliation: Center for Surgical Medical Acute Care Research and Transitions, Birmingham Veterans Affairs Medical Center; Department of Surgery, University of Alabama at Birmingham.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Richman
authors.affiliation: Center for Surgical Medical Acute Care Research and Transitions, Birmingham Veterans Affairs Medical Center; Department of Surgery, University of Alabama at Birmingham.
authors.forename: Mary T
authors.initials: MT
authors.lastname: Hawn
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D011787:Quality of Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: HAC; arthroplasty; hospital acquired conditions; predictors; readmission; strongest predictor