4.6 Article

Thirty-Day Readmission Following Total Hip and Knee Arthroplasty - A Preliminary Single Institution Predictive Model

期刊

JOURNAL OF ARTHROPLASTY
卷 29, 期 8, 页码 1532-1538

出版社

CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.arth.2014.02.030

关键词

30-day readmission; value-based healthcare; total joint arthroplasty; risk stratification

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  1. Vanderbilt University

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We sought to identify demographic or care process variables associated with increased 30-day readmission within the total hip and knee arthroplasty patient population. Using this information, we generated a model to predict 30-day readmission risk following total hip and knee arthroplasty procedures. Longer index length of stay, discharge disposition to a nursing facility, blood transfusion, general anesthesia, anemia, anticoagulation status prior to index admission, and Charlson Comorbidity Index greater than 2 were identified as independent risk factors for readmission. Care process factors during the hospital stay appear to have a large predictive value for 30-day readmission. Specific comorbidities and patient demographic factors showed less significance. The predictive nomogram constructed for primary total joint readmission had a bootstrap-corrected concordance statistic of 0.76. (C) 2014 Elsevier Inc. All rights reserved.

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