Management of Modifiable Risk Factors Prior to Primary Hip and Knee Arthroplasty

• DOI: 10.2106/jbjs.n.01196
• Publication Date: 2015-12-02T18:48:14Z
• Authors: Sreevathsa Boraiah; LiJin Joo; Ifeoma A Inneh; Parthiv Rathod; Morteza Meftah; Philip Band; Joseph A Bosco; Richard Iorio
• Keywords: Hip Arthroplasty

Background: Preoperative risk stratification and optimization of preoperative care may be helpful in reducing readmission rates after primary total joint arthroplasty. Assessment the predictive value individual modifiable factors without a tool to assess cumulative not provide proper patients with regard potential readmissions. As part Perioperative Orthopaedic Surgical Home model, we developed scoring system, Readmission Risk Tool (RRAT), which allows for undergoing elective arthroplasty at our institution. The purpose this study was analyze relationship between RRAT score hip or knee Methods: RRAT, is scored incrementally on basis number severity comorbidities, used generate scores cohort 207 readmitted two cohorts (one random one age-matched) 234 non-readmitted each. Regression analysis performed strength association We also calculated odds ratio (OR) each level identify relatively higher readmission. Results: There were (2.08%) readmissions among 9930 over six-year period (2008 through 2013). site infection most common cause (ninety-three cases, 45%). median 3 (IQR [interquartile range], 1 4) (IQR, 0 2) groups, respectively. An ≥3 significantly associated Conclusions: Population health management, cost-effective care, outcomes maximize are new maxims health-care delivery United States. found that had significant could potentially clinically useful mitigation.