Causes and Predictors of 30-Day Readmission After Shoulder and Knee Arthroscopy: An Analysis of 15,167 Cases.
Purpose: To evaluate the incidence, causes, and risk factors for unplanned 30-day readmission after shoulder and knee arthroscopy.Methods: A multicenter, prospective clinic registry, the American College of Surgeons National Surgical Quality Improvement Program, was queried for Current Procedural Te...
| Published in: | Arthroscopy: The Journal of Arthroscopy & Related Surgery Vol. 31; no. 6; pp. 1035 - 1036 |
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| Main Authors: | , , , , , , |
| Format: | research Journal Article |
| Published: |
Wiley-Blackwell
Jun2015
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109744419&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109744419 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07498063 10OH jtl: Arthroscopy: The Journal of Arthroscopy & Related Surgery issn: 07498063 maglogo: N pubinfo: dt: Jun2015 vid: 31 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 109744419 NLM26048765 2013040712 10.1016/j.arthro.2015.03.029 NLM26048765 109744419 ppf: 1035 ppct: 1 formats: tig: atl: Causes and Predictors of 30-Day Readmission After Shoulder and Knee Arthroscopy: An Analysis of 15,167 Cases. aug: au: Westermann, Robert W Pugely, Andrew J Ries, Zachary Amendola, Annunziato Martin, Christopher T Gao, Yubo Wolf, Brian R sug: ab: Purpose: To evaluate the incidence, causes, and risk factors for unplanned 30-day readmission after shoulder and knee arthroscopy.Methods: A multicenter, prospective clinic registry, the American College of Surgeons National Surgical Quality Improvement Program, was queried for Current Procedural Terminology codes representing the most common shoulder and knee arthroscopic procedures. Unplanned readmissions within 30 days were evaluated dichotomously, and causes of readmission were identified. Univariate and multivariate logistic regression analyses were used to identify variables predictive of readmission.Results: In total, we identified 15,167 patients who underwent shoulder and knee arthroscopic procedures in 2012. Overall, 136 (0.90%) were readmitted within 30 days, and the rates were similar after shoulder (0.86%) and knee (0.92%) procedures. Readmissions were most common after arthroscopic debridement of the knee (1.56%) and lowest after rotator cuff and labral repairs (0.68%) and cruciate reconstructions (0.78%). The most common causes of readmission were surgical-site infections (37.1%), deep venous thrombosis and pulmonary embolism (17.1%), and postoperative pain (7.1%). Multivariate analysis identified age older than 80 years (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.5 to 8.1), chronic steroid use (OR, 3.3; 95% CI, 1.5 to 7.2), and elevated American Society of Anesthesiologists class (OR, 4.2; 95% CI, 1.4 to 12.0) as independent risk factors for readmission.Conclusions: The rate of unplanned readmissions within 30 days of shoulder and knee arthroscopic procedures is low, at 0.92%, with wound-related complications being the most common cause. In patients with advanced age, with chronic steroid use, and with chronic systemic disease, the risk of readmission may be higher. These findings may aid in the informed-consent process, patient optimization, and the quality-reporting risk-adjustment process.Level Of Evidence: Level III, prognostic study. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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