title: Predictors of hospital readmission following revision total knee arthroplasty.
abstract: OBJECTIVE
  Hospital readmission is emerging as an important quality measure, yet modifiable predictors of readmission remain unknown. This study was designed to identify risk factors for readmission following revision total knee arthroplasty.
  
  
  METHODS
  The National Surgical Quality Improvement Program dataset was queried to identify patients undergoing revision total knee arthroplasty from 2011 to 2012. Patient demographics, medical co-morbidities, laboratory values, surgical characteristics and surgical outcomes were examined using bivariate and multivariate logistic regression to identify significant predictors for readmission within 30 days of discharge.
  
  
  RESULTS
  There were 108 readmissions (6.2 %) among 1754 patients. Risk factors for readmission included a history of transient ischaemic attack/cerebrovascular accident (OR 3.47; 13 95 % CI 1.30, 9.25), female sex (OR 1.75, 95 % CI 1.15, 2.68) and general anaesthesia (OR 14 1.74, 95 % CI 1.09, 2.79). Hypertension treated with medication (OR 0.61, 95 % CI 0.39, 0.96) was associated with a lower risk of readmission. Post-operative complications that were significant predictors of hospital readmission included periprosthetic joint infection (OR 15.09, 95 % CI 5.57, 40.91), superficial wound infection (OR 16.57, 95 % CI 5.82, 47.22) and deep venous thrombosis (OR 8.59, 95 % CI 2.36, 31.24).
  
  
  CONCLUSIONS
  The preferred use of neuraxial anaesthesia and coordinated discharge planning in patients with a history of transient ischaemic attack/cerebrovascular accident may reduce the risk of readmission following discharge after revision total knee arthroplasty. Additionally, patients with post-operative infections and deep venous thrombosis following these procedures can benefit from close observation in the first weeks following discharge to minimize the likelihood of readmission.
  
  
  METHODS
  III.
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, TX, 79920, USA.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Belmont
authors.affiliation: Department of Orthopaedic Surgery, Anderson Orthopaedic Institute, 2501 Parker's Lane, Alexandria, VA, 22306, USA.
authors.forename: Gens P
authors.initials: GP
authors.lastname: Goodman
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, TX, 79920, USA.
authors.forename: Marina
authors.initials: M
authors.lastname: Rodriguez
authors.affiliation: Statistical Consulting Laboratory, University of Texas at El Paso, El Paso, TX, 79968, USA.
authors.forename: Julia O
authors.initials: JO
authors.lastname: Bader
authors.affiliation: Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, TX, 79920, USA.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Waterman
authors.affiliation: Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. ajschoen@neomed.edu.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Schoenfeld
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015897:Comorbidity; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000592:standards; D011183:Postoperative Complications; D058996:Quality Improvement; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Complications; Hospital readmission; NSQIP; Revision total knee arthroplasty