The Effect of Comorbidities on Discharge Disposition and Readmission for Total Joint Replacement Patients

• Published in: The Journal of arthroplasty
• Main Authors: Sikora-Klak, Jakub, MD, Zarling, Bradley, MD, Bergum, Christopher, BS, Flynn, Jeffrey C., PhD, Markel, David C., MD
• Format: Journal Article
• Language: English
• Published: 2016
• Subjects: Orthopedics; discharge disposition; knee arthroplasty; comorbidities; readmission; VTE; smoking; hip arthroplasty; Gender; prospective; age; BMI
• ISSN: 0883-5403
• DOI: 10.1016/j.arth.2016.11.035

Abstract Background As the annual demand and number of TJA cases increase, so do concerns of outcomes of patient with specific comorbidities relative to outcomes and costs of care. Methods The study cohort included 2009 primary total knee arthroplasty patients and 905 total hip arthroplasty patients. Discharge disposition was classified as discharge to any facility or home. The comorbidities of the patients who were readmitted and those without a ninety-day event were also evaluated. Results In the TKA population, age, female gender, non-smoking status, VTE history, and diabetes were significantly associated with discharge to ECF on univariate analysis, unlike BMI. With multivariate analyses, female gender, age, VTE history, and diabetes were associated with ECF placement, but smoking was not. In the THA population, age, female gender, and non-smoking status, were significantly associated with discharge to ECF on univariate analysis, while BMI, diabetes, and VTE history were not. On multivariate analyses, female gender and age were associated with ECF, but smoking was not. The only significant finding for the readmission data was an increased rate of readmission for TKA patients of older age. Conclusions The potential of projecting patient discharge and readmission allows physicians to counsel patients and improve patient expectations.