Thirty-day readmission following total hip and knee arthroplasty - a preliminary single institution predictive model

J Arthroplasty. 2014 Aug;29(8):1532-8. doi: 10.1016/j.arth.2014.02.030. Epub 2014 Mar 4.


We sought to identify demographic or care process variables associated with increased 30-day readmission within the total hip and knee arthroplasty patient population. Using this information, we generated a model to predict 30-day readmission risk following total hip and knee arthroplasty procedures. Longer index length of stay, discharge disposition to a nursing facility, blood transfusion, general anesthesia, anemia, anticoagulation status prior to index admission, and Charlson Comorbidity Index greater than 2 were identified as independent risk factors for readmission. Care process factors during the hospital stay appear to have a large predictive value for 30-day readmission. Specific comorbidities and patient demographic factors showed less significance. The predictive nomogram constructed for primary total joint readmission had a bootstrap-corrected concordance statistic of 0.76.

Keywords: 30-day readmission; risk stratification; total joint arthroplasty; value-based healthcare.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / statistics & numerical data*
  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / statistics & numerical data*
  • Blood Transfusion
  • Case-Control Studies
  • Comorbidity
  • Databases, Factual / statistics & numerical data
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Models, Statistical
  • Outcome and Process Assessment, Health Care*
  • Patient Readmission / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Young Adult