Lower outpatient arthroplasty risk assessment score may predict better outcomes after TJA
Click Here to Manage Email Alerts
Key takeaways:
- Lower outpatient arthroplasty risk assessment score was predictive of same- and next-day discharge.
- Lower score also was predictive of fewer complications and readmissions.
DALLAS — Results presented here showed lower outpatient arthroplasty risk assessment score prior to total joint arthroplasty was predictive of same- and next-day discharge and fewer complications and readmissions.
“However, before we take all of our patients to the ASC for their revision, I think more granulated data are needed to refine the model’s accuracy to safely do this,” Leonard T. Buller, MD, FAAOS, of Indiana University Health, said in his presentation at the American Association of Hip and Knee Surgeons Annual Meeting.
To determine whether the outpatient arthroplasty risk assessment (OARA) score could predict outcomes in revision joint replacement, Buller and colleagues analyzed data from 366 revision joint replacements between 2017 and 2023.
“Classification regression tree models were developed to identify OARA score cutoff points that optimize predicting those outcomes of interest,” Buller said. “Those cutoff points were then entered into multivariate models to evaluate the predictability on the outcomes.”
Buller said a cutoff of 113 points was the lowest OARA score that provided the greatest difference in length of stay.
“At a score of 113 points, over 70% of patients were discharged on or after postoperative day number 2,” Buller said.
He added that patients who required a longer inpatient stay had significantly higher preoperative OARA scores.
“In the multivariable model, a score under 113 points was associated with a 3.2 times higher likelihood of same- or next-day discharge,” Buller said.
Patients with significantly higher preoperative OARA scores experienced complications within 90 days postoperatively, according to Buller. A multivariate model showed patients had nearly a fivefold higher likelihood of 90-day complications if they had a preoperative OARA score of more than 113 points. Similarly, Buller said patients with significantly higher preoperative OARA scores had readmission within 90 days, with an OARA score of more than 113 points associated with a 4.2 times higher likelihood of 90-day readmission.
“Patients who had a readmission within 90 days had significantly higher preoperative OARA scores,” Buller said. “Again, the multivariable model scored over 113 points was associated with a 4.2 times higher likelihood of 90-day readmission.”
Collapse
Buller LT, et al. Paper 53. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 7-10, 2024; Dallas.
Click Here to Manage Email Alerts