Black patients older than 80 years may be at high risk for return ED visit after THA, TKA
Click Here to Manage Email Alerts
Black race, age older than 80 years and multiple comorbidities are independent risk factors for unplanned emergency department visits after total hip and knee arthroplasties, according to published results.
Researchers retrospectively analyzed 4,649 primary THA and 5,830 primary TKA procedures with a similar number of patients returning to the ED at least once within 90 days of surgery (421 THA patients, 9.1% and 516 TKA patients, 8.9%). The procedures were identified from an institutional database at one tertiary academic medical center, and all were performed separately, according to the study.
After univariable and multivariable analysis, researchers found black race, age older than 80 years, congestive heart failure, valvular heart disease, metastatic disease, peripheral vascular disease, alcoholism, drug use, depression and discharge to a skilled nursing facility were significant independent predictors of an unplanned, return ED visit within 90 days of THA.
Additionally, black race, liver insufficiency, cancer and pulmonary hypertension were significant independent predictors of an unplanned, return ED visit within 90 days of TKA.
According to the study, patients covered by Medicare also had a high risk for an unplanned ED visit, as 58.1% of patients returning to the ED after THA and 64.3% of patients returning to the ED after TKA were Medicare patients.
“The primary risk factors for ED return differ for THA and TKA, and this is not currently reflected in the medical severity diagnosis-related group system,” the researchers wrote. “Specifically, black patients with multiple comorbidities are at high risk for unplanned ED visits following THA. This should be considered in patient counseling and outreach programs when attempting to mitigate the postoperative risks and to decrease 90-day resource utilization in this patient population,” they wrote.
Collapse
Click Here to Manage Email Alerts