Patient-Related Risk Factors for Unplanned 30-Day Hospital Readmission Following Primary and Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis
Total knee arthroplasty (TKA) is a highly effective procedure for advanced osteoarthritis of the knee. Thirty-day hospital readmission is an adverse outcome related to complications, which can be mitigated by identifying associated risk factors. We aimed to identify patient-related characteristics a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/1/134 |
| _version_ | 1797542513351852032 |
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| author | Daniel Gould Michelle M Dowsey Tim Spelman Olivia Jo Wassif Kabir Jason Trieu James Bailey Samantha Bunzli Peter Choong |
| author_facet | Daniel Gould Michelle M Dowsey Tim Spelman Olivia Jo Wassif Kabir Jason Trieu James Bailey Samantha Bunzli Peter Choong |
| author_sort | Daniel Gould |
| collection | DOAJ |
| description | Total knee arthroplasty (TKA) is a highly effective procedure for advanced osteoarthritis of the knee. Thirty-day hospital readmission is an adverse outcome related to complications, which can be mitigated by identifying associated risk factors. We aimed to identify patient-related characteristics associated with unplanned 30-day readmission following TKA, and to determine the effect size of the association between these risk factors and unplanned 30-day readmission. We searched MEDLINE and EMBASE from inception to 8 September 2020 for English language articles. Reference lists of included articles were searched for additional literature. Patients of interest were TKA recipients (primary and revision) compared for 30-day readmission to any institution, due to any cause, based on patient risk factors; case series were excluded. Two reviewers independently extracted data and carried out critical appraisal. In-hospital complications during the index admission were the strongest risk factors for 30-day readmission in both primary and revision TKA patients, suggesting discharge planning to include closer post-discharge monitoring to prevent avoidable readmission may be warranted. Further research could determine whether closer monitoring post-discharge would prevent unplanned but avoidable readmissions. Increased comorbidity burden correlated with increased risk, as did specific comorbidities. Body mass index was not strongly correlated with readmission risk. Demographic risk factors included low socioeconomic status, but the impact of age on readmission risk was less clear. These risk factors can also be included in predictive models for 30-day readmission in TKA patients to identify high-risk patients as part of risk reduction programs. |
| first_indexed | 2024-03-10T13:31:37Z |
| format | Article |
| id | doaj.art-12c1deee6159472b87170ba8b39b4d7e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T13:31:37Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-12c1deee6159472b87170ba8b39b4d7e2023-11-21T07:51:00ZengMDPI AGJournal of Clinical Medicine2077-03832021-01-0110113410.3390/jcm10010134Patient-Related Risk Factors for Unplanned 30-Day Hospital Readmission Following Primary and Revision Total Knee Arthroplasty: A Systematic Review and Meta-AnalysisDaniel Gould0Michelle M Dowsey1Tim Spelman2Olivia Jo3Wassif Kabir4Jason Trieu5James Bailey6Samantha Bunzli7Peter Choong8Department of Surgery, University of Melbourne, St. Vincent’s Hospital Melbourne, 3065 Melbourne, AustraliaDepartment of Surgery, University of Melbourne, St. Vincent’s Hospital Melbourne, 3065 Melbourne, AustraliaDepartment of Surgery, University of Melbourne, St. Vincent’s Hospital Melbourne, 3065 Melbourne, AustraliaDepartment of Surgery, University of Melbourne, St. Vincent’s Hospital Melbourne, 3065 Melbourne, AustraliaDepartment of Surgery, University of Melbourne, St. Vincent’s Hospital Melbourne, 3065 Melbourne, AustraliaDepartment of Surgery, University of Melbourne, St. Vincent’s Hospital Melbourne, 3065 Melbourne, AustraliaSchool of Computing and Information Systems, University of Melbourne, 3052 Melbourne, AustraliaDepartment of Surgery, University of Melbourne, St. Vincent’s Hospital Melbourne, 3065 Melbourne, AustraliaDepartment of Surgery, University of Melbourne, St. Vincent’s Hospital Melbourne, 3065 Melbourne, AustraliaTotal knee arthroplasty (TKA) is a highly effective procedure for advanced osteoarthritis of the knee. Thirty-day hospital readmission is an adverse outcome related to complications, which can be mitigated by identifying associated risk factors. We aimed to identify patient-related characteristics associated with unplanned 30-day readmission following TKA, and to determine the effect size of the association between these risk factors and unplanned 30-day readmission. We searched MEDLINE and EMBASE from inception to 8 September 2020 for English language articles. Reference lists of included articles were searched for additional literature. Patients of interest were TKA recipients (primary and revision) compared for 30-day readmission to any institution, due to any cause, based on patient risk factors; case series were excluded. Two reviewers independently extracted data and carried out critical appraisal. In-hospital complications during the index admission were the strongest risk factors for 30-day readmission in both primary and revision TKA patients, suggesting discharge planning to include closer post-discharge monitoring to prevent avoidable readmission may be warranted. Further research could determine whether closer monitoring post-discharge would prevent unplanned but avoidable readmissions. Increased comorbidity burden correlated with increased risk, as did specific comorbidities. Body mass index was not strongly correlated with readmission risk. Demographic risk factors included low socioeconomic status, but the impact of age on readmission risk was less clear. These risk factors can also be included in predictive models for 30-day readmission in TKA patients to identify high-risk patients as part of risk reduction programs.https://www.mdpi.com/2077-0383/10/1/134readmissionarthroplastykneeriskpatientprognosis |
| spellingShingle | Daniel Gould Michelle M Dowsey Tim Spelman Olivia Jo Wassif Kabir Jason Trieu James Bailey Samantha Bunzli Peter Choong Patient-Related Risk Factors for Unplanned 30-Day Hospital Readmission Following Primary and Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis Journal of Clinical Medicine readmission arthroplasty knee risk patient prognosis |
| title | Patient-Related Risk Factors for Unplanned 30-Day Hospital Readmission Following Primary and Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis |
| title_full | Patient-Related Risk Factors for Unplanned 30-Day Hospital Readmission Following Primary and Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis |
| title_fullStr | Patient-Related Risk Factors for Unplanned 30-Day Hospital Readmission Following Primary and Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Patient-Related Risk Factors for Unplanned 30-Day Hospital Readmission Following Primary and Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis |
| title_short | Patient-Related Risk Factors for Unplanned 30-Day Hospital Readmission Following Primary and Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis |
| title_sort | patient related risk factors for unplanned 30 day hospital readmission following primary and revision total knee arthroplasty a systematic review and meta analysis |
| topic | readmission arthroplasty knee risk patient prognosis |
| url | https://www.mdpi.com/2077-0383/10/1/134 |
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