Clinical Outcomes and Costs Within 90 Days of Primary or Revision Total Joint Arthroplasty

The Journal of Arthroplasty
Christine I Nichols, Joshua G Vose

Abstract

This study evaluated the factors and costs associated with discharge destination and readmission, within 90 days of surgery, for primary or revision total knee arthroplasty (TKA) and total hip arthroplasty (THA). This retrospective database analysis used health care claims from the Truven MarketScan Database (2009-2013). Patients were selected if aged ≥18 years, with continuous health plan enrollment from 3-month baseline through 3-month follow-up. Logistic regression and Cox proportional hazard models were used to analyze factors associated with discharge destination and risk of readmission. Total 90-day costs were calculated for different patient pathways of care, dependent on complications, discharge destination, and readmission status. A total of 323,803 primary TKA, 25,354 revision TKA, 159,390 primary THA, and 17,934 revision THA cases met selection criteria. All-cause complications occurred in 2.5%, 37.2%, 2.6%, and 35.0% of each cohort. Complications, transfusions, and length of stay ≥3 days were associated with greater odds of discharge to home with home health services or skilled nursing facility (SNF) vs home under self-care (P < .001 all cohorts), whereas discharge to home with home health services or SNF was associ...Continue Reading

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Citations

Nov 1, 2016·Clinical Orthopaedics and Related Research·P Maxwell CourtneyAtul F Kamath
Aug 11, 2016·The Journal of Arthroplasty·P Maxwell CourtneyDavid C Markel
Sep 8, 2016·The Journal of Arthroplasty·Brandon A HaghverdianRan Schwarzkopf
Sep 25, 2016·The Journal of Arthroplasty·J Joseph GholsonJohn J Callaghan
Dec 8, 2017·The Bone & Joint Journal·N B FrischC J Della Valle
Aug 3, 2018·Journal of Comparative Effectiveness Research·Nadia SuttonStephen S Johnston
Feb 13, 2018·Journal of Racial and Ethnic Health Disparities·Robert S WhiteZachary A Turnbull
Aug 31, 2018·Knee Surgery & Related Research·Vivek TiwariTae Kyun Kim
Jun 14, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Michael D RudyNidhi Rohatgi
Aug 5, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Nicolas A SelemonPeter K Sculco
Nov 26, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Armin ArshiAlexandra I Stavrakis
Jun 26, 2018·Physiotherapy Theory and Practice·Will Bolt, Deborah M Wendland
Feb 28, 2019·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Maria BautistaDaniel Monsalvo
Oct 19, 2019·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Shweta PathakRobert O Morgan
Feb 26, 2019·SAGE Open Medical Case Reports·Wayne G PaproskyJeffrey M Muir
Jan 4, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Jay L MottlaMark W Zawadsky
Jul 15, 2017·Clinical Orthopaedics and Related Research·Shweta PathakRobert O Morgan
Apr 9, 2017·Clinical Orthopaedics and Related Research·Thomas J ParisiHany S Bedair
Jan 22, 2017·Clinical Orthopaedics and Related Research·Steven M KurtzMichael T Manley
Nov 7, 2019·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Azeem Tariq MalikThuan V Ly
Feb 8, 2021·The Journal of Arthroplasty·Robert A BurnettP Maxwell Courtney
Feb 23, 2021·The Journal of Arthroplasty·Emanuele ChisariP Maxwell Courtney
Mar 23, 2021·Clinics in Orthopedic Surgery·Suresh K NayarUmasuthan Srikumaran
Apr 13, 2021·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Pramod KamalapathyQuanjun Cui
Jul 6, 2020·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Sung-Sahn LeeYoung-Wan Moon
Dec 23, 2020·The Journal of Arthroplasty·Tony S ShenEdwin P Su
Sep 19, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Venkatsaiakhil TirumalaYoung-Min Kwon

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