Risk Factors for Early Readmission and Reoperation After Outpatient Total Hip Arthroplasty.

Abstract

Outpatient total hip arthroplasty (THA) is a safe option for select patients. The purpose of this study was to analyze a national database and understand risk factors that lead to unplanned early readmission and reoperation after outpatient THA. The National Surgical Quality Improvement Program database was used to collect outpatient THAs performed from 2013 to 2020. The outpatient setting was defined as a reported hospital length of stay of 23 hours or less. Data variables collected included patient demographics, medical comorbidities, American Society of Anesthesiologists classification, functional status, preoperative laboratory values, National Surgical Quality Improvement Program morbidity probability, and 30-day readmissions and reoperations. A total of 15,055 patients underwent outpatient THA. Mean age was 62.6 years, and 52.1% of patients were men. Mean body mass index was 29.3 kg/m2. The overall rate of readmission was 1.8%, and the reoperation rate was 1.0%. Patients with a 30-day readmission were older (P<.01), with a higher incidence of hypertension (P<.01), steroid use (P<.01), and bleeding disorders (P=.01). Patients with a 30-day reoperation had higher body mass index (P<.01), hypertension (P<.01), and steroid use (P<.01). Regression analysis demonstrated that independent risk factors for readmission were age (P<.01) and steroid use (P<.01). Risk factors for 30-day reoperation were hypertension (P<.01) and steroid use (P<.01). There is a higher risk of early readmission after outpatient THA for older patients with hypertension, bleeding disorders, and steroid use. Patients with hypertension and steroid use have a higher risk for reoperation after outpatient THA. Modifiable risk factors should be addressed preoperatively, with proper patient selection for outpatient THA. [Orthopedics. 2024;47(1):e38-e44.].