Abstract
Unplanned readmission after total hip arthroplasty (THA) has an increasing prevalence
in the United States. Readmissions are a metric for a hospital's quality of care,
yet the reasons behind them are mixed. In this changing health-care environment, it
is critical for institutions to identify the risk factors for unplanned readmissions
following a THA. Retrospective chart review and hospital administrative database query
were used to report causes, demographics, and medical comorbidities linked to a 30-day
readmission after primary THA at a teaching community hospital system. This study
identified 4,459 primary THA procedures, of which 96 (2.2%) were unplanned readmissions.
Periprosthetic fracture (20.8%) and periprosthetic infection (17.7%) were the most
common causes of readmission. Patients discharged to rehab (odds ratio [OR], 2.44;
95% confidence interval [CI], 1.36–4.37; p = 0.0026) were correlated significantly with the risk of 30-day readmission. Anemia
(OR, 2.62; 95% CI, 1.44–4.79; p = 0.0016), obstructive sleep apnea (OR, 2.27; 95% CI, 1.17–4.4; p = 0.0150), and asthma (OR, 2.51; 95% CI, 1.17–5.40; p = 0.0184) were significant independent risk factors. Charlson comorbidity index (p = 0.3634) was not shown to correlate with a quicker readmission within 30 days of
discharge. Patients with a history of anemia, obstructive sleep apnea, and asthma
should be medically optimized before and after undergoing THA in the community setting.
Implementing postsurgical emphasis on discharging patients with home care options
rather than transferring them to a rehabilitation facility may prevent 30-day readmissions.
Keywords
adult reconstruction - total hip arthroplasty - readmissions - medical comorbidities
