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J Arthroplasty. 2014 Aug;29(8):1532-8. doi: 10.1016/j.arth.2014.02.030. Epub 2014 Mar 4.

Thirty-day readmission following total hip and knee arthroplasty - a preliminary single institution predictive model.

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Department of Orthopaedic surgery, Vanderbilt University Medical Center. Electronic address:
Department of Orthopaedic Surgery Cleveland Clinic, Adult Reconstruction Section, Cleveland Clinic, Ohio.
Lerner Research Institute, Cleveland, Ohio.


We sought to identify demographic or care process variables associated with increased 30-day readmission within the total hip and knee arthroplasty patient population. Using this information, we generated a model to predict 30-day readmission risk following total hip and knee arthroplasty procedures. Longer index length of stay, discharge disposition to a nursing facility, blood transfusion, general anesthesia, anemia, anticoagulation status prior to index admission, and Charlson Comorbidity Index greater than 2 were identified as independent risk factors for readmission. Care process factors during the hospital stay appear to have a large predictive value for 30-day readmission. Specific comorbidities and patient demographic factors showed less significance. The predictive nomogram constructed for primary total joint readmission had a bootstrap-corrected concordance statistic of 0.76.


30-day readmission; risk stratification; total joint arthroplasty; value-based healthcare

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