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Length of stay following TKA not associated with increased readmission rates
Vorhies JS, et al. Clin Orthop Relat Res. 2011. doi: 10.1007/s11999-011-1957-0
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The reduction in length of stay following total knee arthroplasty is not associated with increased readmission rates in the Medicare population, according to researchers in California.
Readmissions are most commonly caused through cardiac-related events, the authors added — suggesting that optimizing the patient’s cardiac status prior to discharge in addition to regular primary care physician follow-up could reduce readmission rates.
The researchers performed a retrospective review of readmission rates and reasons, as well as length of stay, in 4,057 Medicare total knee arthroplasty (TKA) patients from 2002 through 2007. They found an overall readmission rate of 5.6% within 30 days of discharge, with the 10 most common readmission reasons being congestive heart failure (20.4%), chronic ischemic heart disease (13.9%), cardiac dysrhythmias (12.5%), pneumonia (10.8%), osteoarthritis (9.4%), general symptoms (7.4%), acute myocardial infarction (7.0%), other rehabilitation procedures (6.3%), diabetes mellitus (6.3%), and fluid, electrolyte and acid-base balance disorders (5.9%).
The authors reported no significant difference in readmission rates between 2002 and 2004 as compared with 2005 through 2007. However, they noted a reduction in length of stay between the two periods.