30 days re-admission in an articular Joint Arthroplasty center. A cohort Study
DOI:
https://doi.org/10.1016/j.rccot.2021.01.004Keywords:
readmission, arthroplasty, RTC, RTR, 30 days, risk factors, complicationAbstract
Background: Joint replacements are always defined as safe and successful procedures for the treatment of severe osteoarthritis of the hip and knee around the world. Rates of readmission within initial post surgical 30 days and complications are described as a measure to assess quality standards. In Colombia the behavior of the standards are mainly unknown. Aim of study is to provide information from a specialized in joint replacements center in Colombia.Methods: A prospective observational study was carried out on a cohort of 1,126 patients with 626 total hip replacements (THR) and 500 knee replacements (TKR), who underwent surgery between 2011-2015 at a University Hospital in Bogotá, Colombia. 30-day readmission rates and complications were reported. The associations between sociodemographic and clinical variables with readmission and complications were analyzed using a regression model.
Results: 71% of the patients were women, the average age was 63 years for men and 65 years for women. The mean hospital stay was 3.5 days (SD: 0.81-6.29). The 30-day readmission rate for any cause was 10.8% and the rate of complications associated with the procedure was 5.8%. Additional surgical procedures were required in 1.5% of the patients. A statistically significant association was found between the Charlson index greater than 2 (OR = 2.33 [95% CI 1.3-4.18], p = 0.004) and readmission at 30 days. The main complication in THR was dislocation (1.4%) and surgical site infection (4%) in TKR. A significant association was found between complications at 30 days and days of hospitalization (OR = 1.17 [95% CI 1.09-1.25], p = 0.00); and with surgeon 4 in TKR (OR=2.28 [95% CI 1.29-4.01], p=0.04); the other variables did not show significant differences. No differences were found with what is reported in the literature, association with hospital stay and experience of the surgeon.
Discussion: The surgeon’s experience and the application of clinical guidelines that optimize in-hospital processes and regulate the days of hospital stay are related to a better outcome in the evolution of patients in terms of the number of complications and readmissions after 30 days.
Evidence Level: II
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