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Predictors of 30-Day Re-hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective

Year 2022, Volume: 12 Issue: 1, 227 - 234, 30.03.2022
https://doi.org/10.33808/clinexphealthsci.938328

Abstract

Objective: The study was aimed to elucidate risk factors identifiable from ward-derived data of thirty-day re-hospitalization among patients undergoing total hip and total knee arthroplasty.
Methods: The study was designed as a cross-sectional and prospective study. The data of the study were collected through the Patient Sociodemographic Form, the Nurse Physical Assessment and Observation Form, the Charlson Comorbidity Index (CCI), and the Katz Activities of Daily Living (ADL) Scale.
Results: Patients were scored using this CCI system and grouped as high (high CCI group >2, n = 49) and low CCI (low CCI group ≤2, n = 78) with a cut-off score of 2. The 30-day re-hospitalization rate was 14.2%, and the most common reason for re-hospitalization was a surgical infection.
Surgical risk, Activities of daily living dependency, and comorbidities index scores of the patients were not significantly additive effects on rehospitalization (p> 0.05). The results indicate that surgical infection was often the cause of higher rates of re-hospitalization among patients with total knee and total hip arthroplasty.
Conclusions: Conclusions: Orthopedic nurses should close observation of surgical site infection and design an effective discharge following-up order to the prevention of re-hospitalization in patients with“high risk”.

Supporting Institution

YOk

Project Number

YOK

Thanks

The authors would like to thank the participating inpatients in an orthopedic clinic for their support and aid. Particular thanks also to all of the orthopedic nurses, doctors, and hospital management for their understanding and cooperation.

References

  • 1] OECD Indicators. Hip and knee replacement, in Health at a Glance 2017. OECD Publishing, 2017, Paris, [cited 2020 Oct]. Avalaible from: URL: https://doi.org/10.1787/health_glance- 2017-65-en.
  • [2] Truntzer N, Shah K, Jenkins D, Rubin L. Total joint arthroplasty in patients with chronic infectious liver disease. Arthroplast Today 2016;2(2):69–76.
  • [3] Fernandez-Cuadros ME, Perez-Moro OS, Miron-Canelo JA. Age and comorbidities affect quality of life in patients with osteoarthrtitis and knee replacement. Middle East Journal of Rehabilitation and Health Studies 2016;3(4):e40247.
  • [4] Gronbeck C, Cote MP, Lieberman JR, Halawi, M. Risk stratification in primary total joint arthroplasty: the current state of knowledge. Arthroplast Today 2019;5(1):126-131.
  • [5] Loth FL, Giesinger JM, Giesinger K, MacDonald DJ, Simpson AH, Howie CR, Hamilton DF. Impact of comorbidities on outcome after total hip arthroplasty. J Arthroplasty 2017;32(9): 2755- 2761.
  • [6] Causey-Upton R, Howell DM, Kitzman HP. Custer MG, Dressler VD. Factors influencing discharge readiness after total knee replacement. Orthop Nurs 2019; 38(1): 6-14.
  • [7] Chern A, Greenberg ES, Thakore RV, Sathiyakumar V, Obremskey VT, Sethi MK. Factors driving readmissions in tibia and femur fractures. Adv Orthop 2015;74543: 1-6.
  • [8] Bernatz JT, Tueting J, Anderson PA. Thirty-day readmission rates in orthopedics: a systematic review and meta-analysis. PLoS ONE 2015;10(4):e0123593.
  • [9] Longo UG, Matarese M, Arcangeli V, Alciati V, Candela V, Facchinetti G, Marchetti A, De Marinis MG, Denaro, V. Denaro family caregiver strain and challenges when caring for orthopedic patients: a systematic review. Journal Clinical Medicine 2020; 9(1497): 2-19.
  • [10] Avram V, Petruccelli D, Winemaker M, Beer J. Total joint arthroplasty readmission rates and reasons for 30-day hospital readmission. J Arthroplasty 2014; 29(3):465-468.
  • [11] Gardona RGB, Barbosa DA. The importance of clinical practice supported by health assessment tools. Rev Paul Enferm 2018;71(4):1815-1816.
  • [12] Alzaghari O, Wallace DC. The impact of physiological factors on 30-day unplanned rehospitalization in adults with heart failure. J Community Health Nurs 2019;36(1):31-41.
  • [13] Kurtz MS, Lau EC, Ong KL, Adler EM, Kolisek FR, Manley MT. Which hospital and clinical factors drive 30 – and 90-day readmission after TKA? J Arthroplasty 2016;31(10): 2099- 2107.
  • [14] Zadzilika JD, Kilika KA, Calvo C, Suarez JC, Patel PD, Krebs VE. Caregiver burden for patients with severe osteoarthritis significantly decreases by one year after total knee arthroplasty. J Arthroplasty 2018;33(12):3660-3665.
  • [15] Ural A, Kılıç İ. Bilimsel Araştırma Süreci ve Spss ile Veri Analizi. 4.Baskı. Ankara: Detay Yayıncılık; 2013. (Turkish) [16] Özdamar K. SPSS ile Bioistatistik. 4. Baskı. Eskişehir: Nisan Kitabevi; 2001.
  • [17] Gültekin M, Şimşek, E. Palyatif bakımda ağrı yönetimi. T.C. Sağlık Bakanlığı (2018,May 4). Available from: URL: http:// www.palyatifbakim.org.tr/images/klavuzlar/AGRI.pdf
  • [18] Ozyurek P, Yavuz M , Yıldız Ö. Investigation of the risk factors of pressure ulcers in intensive care unit patients: According to the Braden Scale. East J Med 2016;21(1):1-9.
  • [19] Barış VK, İntepeler S, İleri S, Rastgel H. İTAKİ Psikometrik Özelliklerin Değerlendirilmesi. DEUHFED 2020;13(4):214-221. (Turkish)
  • [20] Roffman CE, Buchanana J, Allison GT. Charlson Comorbidities Index. J Physiother 2016;62(3): 242.
  • [21] ASA Physical Status Classification System. The ASA House of Delegates. 2020 Aug 25. Available from: URL: ///C:/Users/ User/Downloads/asa-physical-status-classification-system. pdf.
  • [22] Pehlivanoğlu EÖ, Özkan MU, Balcıoğlu H, Bilge U. Adjustment and reliability of Katz Daily Life Activity measures for elderly in Turkish. Ankara Medical Journal 2018;18(2):219-23.
  • [23] Ramkumar PN, Chu CT, Harris JD, Athiviraham A, Harrington MA, White DL, Berger DH, Naik AD, Li, L.T. Causes and rates of unplanned readmissions after elective primary total joint arthroplasty: a systematic review and meta-analysis. Am J Orthop 2015; 44(9):397-405.
  • [24] Martin CT, Gao Y, Pugely AJ. Incidence and risk factors for 30- day readmissions after hip fracture surgery. Iowa Orthop J 2016;36:155-200.
  • [25] Ramaswamy A, Marchese M, Cole AP, Harmouch S, Friedlander D, Weissman JS, Lipsitz SR, Haider AH, Kibel AS, Schoenfeld AJ, Trinh, Q. Comparison of hospital readmission after total hip and total knee arthroplasty vs spinal surgery after implementation of the hospital readmissions reduction program. JAMA Network Open 2019;2(5):1-11.
  • [26] Schairer WW, Sing DC, Vail TP, Bozic KJ. Causes and frequency of unplanned hospital readmission after total hip arthroplasty. Clin Orthop Relat Res 2014;472(2):464–70.
  • [27] Kelly MP, Calkins TE, Culvern C, Kogan M, Della Valle CJ. Inpatient versus outpatient hip and knee arthroplasty: which has higher patient satisfaction? J Arthroplasty 2018;33(11): 3402-3406.
  • [28] Varacallo MA, Herzog L, Toossi N, Johanson NA. Ten-year trends and independent risk factors for unplanned readmission following elective total joint arthroplasty at a large urban academic hospital. J Arthroplasty 2017;32(6):1739–1746.
  • [29] D’Apuzzo M, Westrich G, Hidaka C, Pan TJ, Lyman S. All-cause versus complication-specific readmission following total knee arthroplasty. Arch Bone Jt Surg 2017, 99(13):1093-1103.
  • [30] Gould D, Dowsey M, Spelman T, Jo I, Kabir W, Trieu J, Choong, P. Patient-related risk factors for unplanned 30-day readmission following total knee arthroplasty: a protocol for a systematic review and meta-analysis. BMJ 2019;8(1):1-8.
Year 2022, Volume: 12 Issue: 1, 227 - 234, 30.03.2022
https://doi.org/10.33808/clinexphealthsci.938328

Abstract

Project Number

YOK

References

  • 1] OECD Indicators. Hip and knee replacement, in Health at a Glance 2017. OECD Publishing, 2017, Paris, [cited 2020 Oct]. Avalaible from: URL: https://doi.org/10.1787/health_glance- 2017-65-en.
  • [2] Truntzer N, Shah K, Jenkins D, Rubin L. Total joint arthroplasty in patients with chronic infectious liver disease. Arthroplast Today 2016;2(2):69–76.
  • [3] Fernandez-Cuadros ME, Perez-Moro OS, Miron-Canelo JA. Age and comorbidities affect quality of life in patients with osteoarthrtitis and knee replacement. Middle East Journal of Rehabilitation and Health Studies 2016;3(4):e40247.
  • [4] Gronbeck C, Cote MP, Lieberman JR, Halawi, M. Risk stratification in primary total joint arthroplasty: the current state of knowledge. Arthroplast Today 2019;5(1):126-131.
  • [5] Loth FL, Giesinger JM, Giesinger K, MacDonald DJ, Simpson AH, Howie CR, Hamilton DF. Impact of comorbidities on outcome after total hip arthroplasty. J Arthroplasty 2017;32(9): 2755- 2761.
  • [6] Causey-Upton R, Howell DM, Kitzman HP. Custer MG, Dressler VD. Factors influencing discharge readiness after total knee replacement. Orthop Nurs 2019; 38(1): 6-14.
  • [7] Chern A, Greenberg ES, Thakore RV, Sathiyakumar V, Obremskey VT, Sethi MK. Factors driving readmissions in tibia and femur fractures. Adv Orthop 2015;74543: 1-6.
  • [8] Bernatz JT, Tueting J, Anderson PA. Thirty-day readmission rates in orthopedics: a systematic review and meta-analysis. PLoS ONE 2015;10(4):e0123593.
  • [9] Longo UG, Matarese M, Arcangeli V, Alciati V, Candela V, Facchinetti G, Marchetti A, De Marinis MG, Denaro, V. Denaro family caregiver strain and challenges when caring for orthopedic patients: a systematic review. Journal Clinical Medicine 2020; 9(1497): 2-19.
  • [10] Avram V, Petruccelli D, Winemaker M, Beer J. Total joint arthroplasty readmission rates and reasons for 30-day hospital readmission. J Arthroplasty 2014; 29(3):465-468.
  • [11] Gardona RGB, Barbosa DA. The importance of clinical practice supported by health assessment tools. Rev Paul Enferm 2018;71(4):1815-1816.
  • [12] Alzaghari O, Wallace DC. The impact of physiological factors on 30-day unplanned rehospitalization in adults with heart failure. J Community Health Nurs 2019;36(1):31-41.
  • [13] Kurtz MS, Lau EC, Ong KL, Adler EM, Kolisek FR, Manley MT. Which hospital and clinical factors drive 30 – and 90-day readmission after TKA? J Arthroplasty 2016;31(10): 2099- 2107.
  • [14] Zadzilika JD, Kilika KA, Calvo C, Suarez JC, Patel PD, Krebs VE. Caregiver burden for patients with severe osteoarthritis significantly decreases by one year after total knee arthroplasty. J Arthroplasty 2018;33(12):3660-3665.
  • [15] Ural A, Kılıç İ. Bilimsel Araştırma Süreci ve Spss ile Veri Analizi. 4.Baskı. Ankara: Detay Yayıncılık; 2013. (Turkish) [16] Özdamar K. SPSS ile Bioistatistik. 4. Baskı. Eskişehir: Nisan Kitabevi; 2001.
  • [17] Gültekin M, Şimşek, E. Palyatif bakımda ağrı yönetimi. T.C. Sağlık Bakanlığı (2018,May 4). Available from: URL: http:// www.palyatifbakim.org.tr/images/klavuzlar/AGRI.pdf
  • [18] Ozyurek P, Yavuz M , Yıldız Ö. Investigation of the risk factors of pressure ulcers in intensive care unit patients: According to the Braden Scale. East J Med 2016;21(1):1-9.
  • [19] Barış VK, İntepeler S, İleri S, Rastgel H. İTAKİ Psikometrik Özelliklerin Değerlendirilmesi. DEUHFED 2020;13(4):214-221. (Turkish)
  • [20] Roffman CE, Buchanana J, Allison GT. Charlson Comorbidities Index. J Physiother 2016;62(3): 242.
  • [21] ASA Physical Status Classification System. The ASA House of Delegates. 2020 Aug 25. Available from: URL: ///C:/Users/ User/Downloads/asa-physical-status-classification-system. pdf.
  • [22] Pehlivanoğlu EÖ, Özkan MU, Balcıoğlu H, Bilge U. Adjustment and reliability of Katz Daily Life Activity measures for elderly in Turkish. Ankara Medical Journal 2018;18(2):219-23.
  • [23] Ramkumar PN, Chu CT, Harris JD, Athiviraham A, Harrington MA, White DL, Berger DH, Naik AD, Li, L.T. Causes and rates of unplanned readmissions after elective primary total joint arthroplasty: a systematic review and meta-analysis. Am J Orthop 2015; 44(9):397-405.
  • [24] Martin CT, Gao Y, Pugely AJ. Incidence and risk factors for 30- day readmissions after hip fracture surgery. Iowa Orthop J 2016;36:155-200.
  • [25] Ramaswamy A, Marchese M, Cole AP, Harmouch S, Friedlander D, Weissman JS, Lipsitz SR, Haider AH, Kibel AS, Schoenfeld AJ, Trinh, Q. Comparison of hospital readmission after total hip and total knee arthroplasty vs spinal surgery after implementation of the hospital readmissions reduction program. JAMA Network Open 2019;2(5):1-11.
  • [26] Schairer WW, Sing DC, Vail TP, Bozic KJ. Causes and frequency of unplanned hospital readmission after total hip arthroplasty. Clin Orthop Relat Res 2014;472(2):464–70.
  • [27] Kelly MP, Calkins TE, Culvern C, Kogan M, Della Valle CJ. Inpatient versus outpatient hip and knee arthroplasty: which has higher patient satisfaction? J Arthroplasty 2018;33(11): 3402-3406.
  • [28] Varacallo MA, Herzog L, Toossi N, Johanson NA. Ten-year trends and independent risk factors for unplanned readmission following elective total joint arthroplasty at a large urban academic hospital. J Arthroplasty 2017;32(6):1739–1746.
  • [29] D’Apuzzo M, Westrich G, Hidaka C, Pan TJ, Lyman S. All-cause versus complication-specific readmission following total knee arthroplasty. Arch Bone Jt Surg 2017, 99(13):1093-1103.
  • [30] Gould D, Dowsey M, Spelman T, Jo I, Kabir W, Trieu J, Choong, P. Patient-related risk factors for unplanned 30-day readmission following total knee arthroplasty: a protocol for a systematic review and meta-analysis. BMJ 2019;8(1):1-8.
There are 29 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Ebru Gelişgen This is me 0000-0002-1972-5963

Pakize Özyürek 0000-0002-5277-6412

Project Number YOK
Publication Date March 30, 2022
Submission Date May 19, 2021
Published in Issue Year 2022 Volume: 12 Issue: 1

Cite

APA Gelişgen, E., & Özyürek, P. (2022). Predictors of 30-Day Re-hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective. Clinical and Experimental Health Sciences, 12(1), 227-234. https://doi.org/10.33808/clinexphealthsci.938328
AMA Gelişgen E, Özyürek P. Predictors of 30-Day Re-hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective. Clinical and Experimental Health Sciences. March 2022;12(1):227-234. doi:10.33808/clinexphealthsci.938328
Chicago Gelişgen, Ebru, and Pakize Özyürek. “Predictors of 30-Day Re-Hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective”. Clinical and Experimental Health Sciences 12, no. 1 (March 2022): 227-34. https://doi.org/10.33808/clinexphealthsci.938328.
EndNote Gelişgen E, Özyürek P (March 1, 2022) Predictors of 30-Day Re-hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective. Clinical and Experimental Health Sciences 12 1 227–234.
IEEE E. Gelişgen and P. Özyürek, “Predictors of 30-Day Re-hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective”, Clinical and Experimental Health Sciences, vol. 12, no. 1, pp. 227–234, 2022, doi: 10.33808/clinexphealthsci.938328.
ISNAD Gelişgen, Ebru - Özyürek, Pakize. “Predictors of 30-Day Re-Hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective”. Clinical and Experimental Health Sciences 12/1 (March 2022), 227-234. https://doi.org/10.33808/clinexphealthsci.938328.
JAMA Gelişgen E, Özyürek P. Predictors of 30-Day Re-hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective. Clinical and Experimental Health Sciences. 2022;12:227–234.
MLA Gelişgen, Ebru and Pakize Özyürek. “Predictors of 30-Day Re-Hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective”. Clinical and Experimental Health Sciences, vol. 12, no. 1, 2022, pp. 227-34, doi:10.33808/clinexphealthsci.938328.
Vancouver Gelişgen E, Özyürek P. Predictors of 30-Day Re-hospitalization After Total Hip and Total Knee Arthroplasty: A Orthopedic Ward Perspective. Clinical and Experimental Health Sciences. 2022;12(1):227-34.

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