title: Causes and Rates of Unplanned Readmissions After Elective Primary Total Joint Arthroplasty: A Systematic Review and Meta-Analysis.
abstract: To address the lack of consensus on the leading reasons for readmissions after primary elective unilateral total joint arthroplasties (TJAs), we performed a systematic review and a meta-analysis to identify overall and cause-specific readmission rates. We performed structured searches of the Medline and Cochrane databases for original reports-published between January 1982 and January 2013-on both 30- and 90-day follow-ups of unique patient populations that underwent elective primary TJA. Random-effects meta-analyses were performed to obtain pooled estimates. For total hip arthroplasty (THA), the overall pooled readmission rate was 5.6% at 30 days and 7.7% at 90 days. For total knee arthroplasty (TKA), the overall rate was 3.3% at 30 days and 9.7% at 90 days. The leading reason for THA readmission was joint-specific at both 30 and 90 days, and the leading reason for TKA readmission was surgical site infection. Our systematic review and meta-analysis established baseline readmission rates in the literature on primary TJA and identified the most common reasons driving readmission for TJA.
authors.affiliation: Surgical Arthritis Service, Hospital for Special Surgery, New York, NY. premramkumar@gmail.com.
authors.forename: Prem N
authors.initials: PN
authors.lastname: Ramkumar
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Chu
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Harris
authors.forename: Aravind
authors.initials: A
authors.lastname: Athiviraham
authors.forename: Melvyn A
authors.initials: MA
authors.lastname: Harrington
authors.forename: Donna L
authors.initials: DL
authors.lastname: White
authors.forename: David H
authors.initials: DH
authors.lastname: Berger
authors.forename: Aanand D
authors.initials: AD
authors.lastname: Naik
authors.forename: Linda T
authors.initials: LT
authors.lastname: Li
mesh_terms: D019643:Arthroplasty, Replacement; D016208:Databases, Factual; D017558:Elective Surgical Procedures; D006801:Humans; D007902:Length of Stay; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012307:Risk Factors