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Preoperative bariatric surgery not increase non-elective readmission rates after TJA
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Although patients who underwent bariatric surgery 2 years prior to total joint arthroplasty were not at risk for non-elective readmissions, bariatric surgery was a significant predictor of elective total joint arthroplasty admissions up to 1 year following index procedure, according to results published in Orthopedics.
“Patients who had bariatric surgery prior to TJA do not have significantly higher non-elective readmission rates at 30-days, 90-days and 1-year when compared to obese and non-obese patients without preoperative [bariatric surgery] BS,” James X. Liu, MD, co-author of the study, told Healio.com/Orthopedics. “However, if elective TJA is counted as an admission, patients with preoperative BS have significantly higher readmission rates. Preoperative BS is not an independent risk factor for non-elective is an independent risk factor for all-cause readmissions following TJA.”
Liu and colleagues divided 343,710 patients who underwent TJA between 2005 and 2014 into those who underwent preoperative bariatric surgery within 2 years of TJA patients who were obese but did not undergo preoperative bariatric surgery and patients who were not obese and did not undergoing bariatric surgery. Researchers compared non-elective and all-cause readmission rates at days, days and year postoperatively among the groups.
Results showed no significant difference in non-elective readmission rates when comparing group 1 with group 2 and group 3. However, researchers found significantly higher all-cause readmission rates at days, days and year among patients in group 1 when elective TJA readmissions were included. Although bariatric surgery was not a risk factor for non-elective readmissions at any time point, results showed bariatric surgery was an independent risk factor for all-cause readmission at all time points when elective TJA admissions were included.
Researchers identified age 65 years and older, African American ethnicity and Medicare or Medicaid coverage as risk factors for non-elective readmission and all-cause readmission at all time points. According to , workers’ compensation and female sex risk factor for all-cause readmission. Patients who underwent primary TJA had lower odds of 30-day, 90-day and 1-year non-elective and all-cause readmissions when performed by high-volume or very high-volume surgeons, results showed. Researchers also noted non-teaching and rural hospitals had greater odds of non-elective and all-cause readmissions at 30-days, 90-days and 1-year. – by Casey Tingle
Disclosures: Liu reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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