Sickle cell disease and readmissions rates after lower extremity arthroplasty: a multistate analysis 2007-2014

J Comp Eff Res. 2019 Apr;8(6):403-422. doi: 10.2217/cer-2018-0098. Epub 2019 Mar 20.


Aim: To compare readmission rates between patients with sickle cell disease (SCD) and non-sickle cell disease undergoing total hip and knee arthroplasty (THA and TKA).

Methods: Identified adult patients who underwent THA or TKA from 2007 to 2014 in California, Florida, New York, Maryland and Kentucky using a multistate database. Outcomes were 30- and 90-day readmission rates, mortality, complications, length of stay and hospital charges. Logistic regression models were used for analysis.

Results: Compared with non-sickle cell disease patients following TKA and THA, SCD patients had higher odds of 30- (odds ratio [OR]: 3.79) and 90-day readmissions (OR: 4.15), mortality (OR: 6.54), more complications, longer length of stay, and higher total charges.

Conclusion: Following TKA and THA, SCD is associated with higher readmissions and worse outcomes.

Keywords: hematology; observational research; outcomes research.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia, Sickle Cell / epidemiology*
  • Anemia, Sickle Cell / mortality
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / mortality
  • Arthroplasty, Replacement, Hip / statistics & numerical data*
  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / mortality
  • Arthroplasty, Replacement, Knee / statistics & numerical data*
  • Comparative Effectiveness Research
  • Female
  • Hospital Charges / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data*
  • Postoperative Complications / epidemiology
  • United States / epidemiology