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    Patient-Related Risk Factors for Unplanned 30-Day Hospital Readmission Following Primary and Revision Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

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    Author
    Gould, D; Dowsey, MM; Spelman, T; Jo, O; Kabir, W; Trieu, J; Bailey, J; Bunzli, S; Choong, P
    Date
    2021-01-01
    Source Title
    Journal of Clinical Medicine
    Publisher
    MDPI
    University of Melbourne Author/s
    Dowsey, Michelle; Bunzli, Samantha
    Affiliation
    Surgery (St Vincent's)
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Gould, D., Dowsey, M. M., Spelman, T., Jo, O., Kabir, W., Trieu, J., Bailey, J., Bunzli, S. & Choong, P. (2021). 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, 10 (1), https://doi.org/10.3390/jcm10010134.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/258822
    DOI
    10.3390/jcm10010134
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795505
    Abstract
    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.

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