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Accelerated discharge after aseptic revision knee arthroplasty is not associated with early readmission and reoperation.

Publication ,  Journal Article
Cochrane, NH; Kim, B; Seyler, TM; Bolognesi, MP; Wellman, SS; Ryan, SP
Published in: Bone Joint J
December 2022

AIMS: In the last decade, perioperative advancements have expanded the use of outpatient primary total knee arthroplasty (TKA). Despite this, there remains limited data on expedited discharge after revision TKA. This study compared 30-day readmissions and reoperations in patients undergoing revision TKA with a hospital stay greater or less than 24 hours. The authors hypothesized that expedited discharge in select patients would not be associated with increased 30-day readmissions and reoperations. METHODS: Aseptic revision TKAs in the National Surgical Quality Improvement Program database were reviewed from 2013 to 2020. TKAs were stratified by length of hospital stay (greater or less than 24 hours). Patient demographic details, medical comorbidities, American Society of Anesthesiologists (ASA) grade, operating time, components revised, 30-day readmissions, and reoperations were compared. Multivariate analysis evaluated predictors of discharge prior to 24 hours, 30-day readmission, and reoperation. RESULTS: Of 21,610 aseptic revision TKAs evaluated, 530 were discharged within 24 hours. Short-stay patients were younger (63.1 years (49 to 78) vs 65.1 years (18 to 94)), with lower BMI (32.3 kg/m2 (17 to 47) vs 33.6 kg/m2 (19 to 54) and lower ASA grades. Diabetes, chronic obstructive pulmonary disease, hypertension, and cancer were all associated with a hospital stay over 24 hours. Single component revisions (56.8% (n = 301) vs 32.4% (n = 6,823)), and shorter mean operating time (89.7 minutes (25 to 275) vs 130.2 minutes (30 to 517)) were associated with accelerated discharge. Accelerated discharge was not associated with 30-day readmission and reoperation. CONCLUSION: Accelerated discharge after revision TKA did not increase short-term complications, readmissions, or reoperations. Further efforts to decrease hospital stays in this setting should be evaluated.Cite this article: Bone Joint J 2022;104-B(12):1323-1328.

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Published In

Bone Joint J

DOI

EISSN

2049-4408

Publication Date

December 2022

Volume

104-B

Issue

12

Start / End Page

1323 / 1328

Location

England

Related Subject Headings

  • Second-Look Surgery
  • Reoperation
  • Patient Readmission
  • Patient Discharge
  • Humans
  • Arthroplasty, Replacement, Knee
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cochrane, N. H., Kim, B., Seyler, T. M., Bolognesi, M. P., Wellman, S. S., & Ryan, S. P. (2022). Accelerated discharge after aseptic revision knee arthroplasty is not associated with early readmission and reoperation. Bone Joint J, 104-B(12), 1323–1328. https://doi.org/10.1302/0301-620X.104B12.BJJ-2022-0372.R2
Cochrane, Niall H., Billy Kim, Thorsten M. Seyler, Michael P. Bolognesi, Samuel S. Wellman, and Sean P. Ryan. “Accelerated discharge after aseptic revision knee arthroplasty is not associated with early readmission and reoperation.Bone Joint J 104-B, no. 12 (December 2022): 1323–28. https://doi.org/10.1302/0301-620X.104B12.BJJ-2022-0372.R2.
Cochrane NH, Kim B, Seyler TM, Bolognesi MP, Wellman SS, Ryan SP. Accelerated discharge after aseptic revision knee arthroplasty is not associated with early readmission and reoperation. Bone Joint J. 2022 Dec;104-B(12):1323–8.
Cochrane, Niall H., et al. “Accelerated discharge after aseptic revision knee arthroplasty is not associated with early readmission and reoperation.Bone Joint J, vol. 104-B, no. 12, Dec. 2022, pp. 1323–28. Pubmed, doi:10.1302/0301-620X.104B12.BJJ-2022-0372.R2.
Cochrane NH, Kim B, Seyler TM, Bolognesi MP, Wellman SS, Ryan SP. Accelerated discharge after aseptic revision knee arthroplasty is not associated with early readmission and reoperation. Bone Joint J. 2022 Dec;104-B(12):1323–1328.

Published In

Bone Joint J

DOI

EISSN

2049-4408

Publication Date

December 2022

Volume

104-B

Issue

12

Start / End Page

1323 / 1328

Location

England

Related Subject Headings

  • Second-Look Surgery
  • Reoperation
  • Patient Readmission
  • Patient Discharge
  • Humans
  • Arthroplasty, Replacement, Knee