Selective Early Hospital Discharge Does Not Increase Readmission but Unnecessary Return to the Emergency Department Is Excessive Across Groups After Primary Total Knee Arthroplasty

The Journal of Arthroplasty
Stephen R RossmanJess H Lonner

Abstract

There has been much attention paid to the ability to optimize outcomes, limit complications, and reduce costs within the episode of care after total joint arthroplasty. Limiting the duration of postoperative hospitalization as well as reducing emergency department (ED) visits and readmissions are additional considerations in the paradigm of cost containment. Our purpose was to evaluate the safety of early hospital discharge after primary total knee arthroplasty (TKA) and to identify the diagnoses responsible for ED visits and readmissions in the postoperative period. We investigated risk factors for readmission in 995 patients undergoing primary TKA. We compared 2 groups: length of hospital stay (LOS) ≤2 or ≥3 days. Analysis included LOS, Charlson score, history of DVT, discharge disposition, and postdischarge ED visits. Patients who stayed ≤2 postoperative days had a significantly lower mean Charlson score and more likely discharged home. Charlson score and history of DVT were predictive of return events. Patients discharged to home were less likely to have return events. More than half of the patients evaluated in the ED were not readmitted. Among patients undergoing primary TKA, it is the health of the patient, and not their...Continue Reading

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Citations

Sep 7, 2016·The Journal of Arthroplasty·Udai S SibiaPaul J King
Jan 29, 2019·Journal of Comparative Effectiveness Research·Christina L CoolMichael A Mont
Aug 31, 2018·Knee Surgery & Related Research·Vivek TiwariTae Kyun Kim
Apr 14, 2020·Clinical Orthopaedics and Related Research·Arianna L GianakosMary K Mulcahey
Nov 13, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Lakshmanan SivasundaramKevin J Malone
Dec 29, 2019·Journal of Orthopaedic Surgery and Research·Qing-Yuan ZhengGuo-Qiang Zhang
Aug 1, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Lakshmanan SivasundaramKevin J Malone
Jul 9, 2017·Current Reviews in Musculoskeletal Medicine·T David Tarity, Marion M Swall
Feb 19, 2021·The Journal of Arthroplasty·Scott A MufflyJesse E Otero
Dec 11, 2020·The Journal of Arthroplasty·Naomi Maldonado-RodriguezTimothy S Leroux
Dec 20, 2020·International Journal of Orthopaedic and Trauma Nursing·Linda M R ChristensenNana Hyldig

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