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No relationship seen between patient risk factors and 90-day readmission after total ankle arthroplasty
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SEATTLE — Patient risk factors were not significantly correlated with 90-day readmission after total ankle arthroplasty, according to a presenter at the American Orthopaedic Foot and Ankle Society Annual Meeting.
“If you look at all-cause 90-day readmissions, we could not find any of the comorbidities or surgical risk factors that could correlate to being readmitted to the hospital,” Samuel B. Adams Jr., MD, said during his presentation. “If you just want to look at the [total ankle replacement] TAR-related 90-day readmissions or [emergency department] ED readmissions, we also found no patient comorbidities or factors that were significantly associated with these readmissions.”
He added, “The presence of congestive heart failure was the only thing that we could find that was significantly associated with wound complications.”
Adams and colleagues prospectively enrolled 1,048 patients who underwent total ankle arthroplasty (TAA) into an ongoing total ankle replacement outcome study from 2007 to 2017. Investigators retrospectively reviewed patient records to determine patient, operative and postoperative characteristics, such as age, gender, race, Charlson-Deyo comorbidity, Elixhauser indices, post-discharge disposition and American Society of Anesthesiologists (ASA) score. Relationships between patient characteristics and 90-day readmission were determined with univariance tests of significance.
Results showed during the 90-day post-discharge periods, 30 patients required readmission after TAA. Of these patients, 23 patients were readmitted due to surgical wound complications. Hypertension, cardiac arrhythmias, depression, obesity, rheumatoid arthritis, diabetes, hypothyroidism and chronic obstructive pulmonary disease were among the comorbidities seen. Patients who were readmitted vs. those who were not had comparable patient characteristics; however, patients who were readmitted were slightly older, had less of a chance of being discharged to either a skilled nursing facility or in-hospital rehabilitation, had a higher ASA score and had a higher Charlson-Deyo comorbidity index.
According to researchers, there were no patient comorbidities that statistically correlated with 90-day readmission. – by Monica Jaramillo
Reference:
Adams SJ, et al. Do patient risk factors impact 90-day readmission after total ankle arthroplasty? Presented at: American Orthopaedic Foot and Ankle Society Annual Meeting; July 12-15, 2017; Seattle.
Disclosure: Adams reports no relevant financial disclosures.