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Patients discharged to facility vs home after revision TJA at greater risk of unplanned readmissions
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Compared with patients who were discharged home after revision total joint arthroplasty, patients who were discharged to either a skilled nursing facility or inpatient rehabilitation facility were 1.30-times to 1.51-times more likely to have an unplanned readmission within 30 days.
Researchers identified 9,973 patients from the American College of Surgeon’s National Surgical Quality Improvement Program database who underwent revision total joint arthroplasty. Investigators used preoperative and postoperative variables to analyze risk factors for discharge placement. A multivariate regression model was used to determine predictors of severe adverse events or minor adverse events prior to discharge.
Results showed home, skilled nursing facilities and inpatient rehabilitation facilities were the most common discharge destinations, with rates of 66%, 23%, and 11%, respectively. Patients discharged to places other than their homes had higher rates of postdischarge 30-day severe adverse events and unplanned readmissions, according to results of a bivariate analysis.
According to results from multivariate analysis, patients who went to skilled nursing facilities had a 1.30-times greater chance of having an unplanned 30-day readmission
compared with patients discharged home. For patients who went to inpatient rehabilitation facilities, the odds were 1.51-times greater compared to patients discharged to their homes. Investigators noted the unplanned 30-day readmission rates were significantly higher in patients who were discharged to inpatient rehabilitation facilities vs. discharged home after patients were stratified by the number of significant risk factors and discharge destination. ‒ by Monica Jaramillo
Disclosures: Keswani reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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