30-day vs. 90-day total joint replacement episodes — which best captures readmissions? 5 notes

A new study published in the Journal of Arthroplasty examines whether 30-day or 90-day readmission reporting for primary total joint replacement is sufficient.

 

The study included 2,586 patients who underwent total hip or knee replacements from Jan. 1, 2013 to Dec. 31, 2015. EHR records were reviewed for all patients and researchers found:

1. There wasn't a difference in proportion of surgery-related readmissions over the 30-day and 90-day timeframe. Around 71 percent of the 30-day readmissions were surgery-related, compared to 60 percent of the 90-day readmissions.

2. More of the 30-day readmissions were reported as surgery-related complications when compared with the amount of readmissions from day 31 to day 90; 71 percent of the complications within the first 30 days were related to surgery, compared to 47 percent of the remaining 60 days in a 90-day episode.

3. In total, there were 104 patients readmitted within the first year of discharge and 52 percent of those readmissions occurred within the first 30 days after surgery; by 90 days after surgery, 79 percent of those readmissions had occurred.

4. Researchers found similar conclusions when examining the 30-and 90-day post-discharge definitions. Around 53 percent of readmissions were reported within 30 days of discharge and 81 percent within 90 days of discharge.

5. Researchers concluded, "A 90-day timeframe is superior in capturing surgery-related readmissions after total joint arthroplasty. Important total hip and knee arthroplasty adverse events may be missed using a 30-day timeframe."

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