Readmissions after Diagnosis of Surgical Site Infection Following Knee and Hip Arthroplasty

2014 ◽  
Vol 35 (2) ◽  
pp. 152-157 ◽  
Author(s):  
Kyle G. Miletic ◽  
Thomas N. Taylor ◽  
Emily T. Martin ◽  
Rahul Vaidya ◽  
Keith S. Kaye
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Hospital Admissions ◽  
Site Infection ◽  
Median Cost ◽  
Readmission Rates ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

Context.Surgical site infection (SSI) after total hip and knee arthroplasty is a common postoperative complication. We sought to determine readmission rates and costs for total hip and knee arthroplasty complicated by SSI.Design.The Thomson Reuters MarketScan database was searched for patients who underwent knee or hip arthroplasty in 2007. From these data, patients who received a diagnosis of SSI and were readmitted after diagnosis were identified.Setting.A population of 31 to 45 million individuals receiving insurance coverage. Patients who underwent knee or hip arthroplasty who experienced a hospitalization for SSI in the year after surgery were analyzed.Outcome Measures.Total readmission rates and costs per readmission at 30, 60, and 90 days and 1 year after diagnosis of SSI.Results.Of the 76,289 case patients with hip or knee replacement in 2007, 1,026 (1.3%) had a hospitalization for SSI within the year after surgery. Among these patients, 310 (30.2%) were subsequently rehospitalized in the year after initial hospitalization specifically due to SSI-related issues. These rehospitalizations were associated with a mean hospital stay of 7.4 ± 11.4 days and a median cost of $20,001 (interquartile range [IQR], $14,057-$30,551). A total of 517 subjects had a subsequent “all-cause” hospitalization during the year after SSI. These rehospitalizations were associated with a mean hospital stay of 6.4 ± 10.4 days and a median cost of $19,870 (IQR, $13,913-$29,728).Conclusions.Readmissions during the year after SSI diagnosis accounted for 1,072 hospital admissions and cost over $25.5 million. These readmissions are costly and might be a future target for decreased reimbursement.

Impact of an Automated Surveillance to Detect Surgical-Site Infections in Patients Undergoing Total Hip and Knee Arthroplasty in Brazil

2016 ◽  
Vol 37 (8) ◽  
pp. 991-993 ◽  
Author(s):  
Luciana B. Perdiz ◽  
Deborah S. Yokoe ◽  
Guilherme H. Furtado ◽  
Eduardo A. S. Medeiros
Keyword(s):  
Retrospective Study ◽  
Surgical Site Infection ◽  
Knee Arthroplasty ◽  
Surgical Site Infections ◽  
Infect Control Hosp ◽  
Site Infection ◽  
Total Hip ◽  
Routine Surveillance ◽  
Hip And Knee Arthroplasty ◽  
Automated Surveillance

In this retrospective study, we compared automated surveillance with conventional surveillance to detect surgical site infection after primary total hip or knee arthroplasty. Automated surveillance demonstrated better efficacy than routine surveillance in SSI diagnosis, sensitivity, and predictive negative value in hip and knee arthroplasty.Infect Control Hosp Epidemiol 2016;37:991–993

Trends in the Incidence of Surgical Site Infection in The Netherlands

2008 ◽  
Vol 29 (12) ◽  
pp. 1132-1138 ◽  
Author(s):  
Judith Manniën ◽  
Susan van den Hof ◽  
Jan Muilwijk ◽  
Peterhans J. van den Broek ◽  
Birgit van Benthem ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
The Netherlands ◽  
Surgical Site Infection ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Surgical Procedure ◽  
Multivariate Logistic Regression Analysis ◽  
Site Infection ◽  
Surveillance Network ◽  
Total Hip

Objective.To evaluate the time trend in the surgical site infection (SSI) rate in relation to the duration of surveillance in The Netherlands.Setting.Forty-two hospitals that participated in the the Dutch national nosocomial surveillance network, which is known as PREZIES (Preventie van Ziekenhuisinfecties door Surveillance), and that registered at least 1 of the following 5 frequently performed surgical procedures for at least 3 years during the period from 1996 through 2006: mastectomy, colectomy, replacement of the head of the femur, total hip arthroplasty, or knee arthroplasty.Methods.Analyses were performed for each surgical procedure. The surveillance time to operation was stratified in consecutive 1-year periods, with the first year as reference. Multivariate logistic regression analysis was performed using a random coefficient model to adjust for random variation among hospitals. All models were adjusted for method of postdischarge surveillance.Results.The number of procedures varied from 3,031 for colectomy to 31,407 for total hip arthroplasty, and the SSI rate varied from 1.6% for knee arthroplasty to 12.2% for colectomy. For total hip arthroplasty, the SSI rate decreased significantly by 6% per year of surveillance (odds ratio [OR], 0.94 [95% confidence interval {CI}, 0.90–0.98]), indicating a 60% decrease after 10 years. Nonsignificant but substantial decreasing trends in the rate of SSI were found for replacement of the head of the femur (OR, 0.94 [95% CI, 0.88–1.00]) and for colectomy (OR, 0.92 [95% CI, 0.83–1.02]).Conclusions.Even though most decreasing trends in the SSI rate were not statistically significant, they were encouraging. To use limited resources as efficiently as possible, we would suggest switching the surveillance to another surgical procedure when the SSI rate for that particular procedure has decreased below the target rate.

POSSIBILITIES OF FORECASTING SURGICAL SITE INFECTION AFTER HIP AND KNEE REPLACEMENT

2020 ◽  
pp. 106-111
Author(s):  
Vorokov A.A. ◽  
Fadeev E.M. ◽  
Spichko A.A. ◽  
Aliev B.G. ◽  
Murzin E.A. ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Site Infection ◽  
Septic Complications ◽  
Decrease Rate ◽  
Total Hip ◽  
Testing Period ◽  
Hip And Knee Arthroplasty ◽  
Prospective Research

1707 Total Hip and Knee Arthroplasty had been retrospectively analyzed for the research. All patients’ data (non-complicated post- Hip and Knee Arthroplasty (1st group - 1579 patients) and post- Hip and Knee Arthroplasty with surgical site infection in 12 months (2nd group - 128 patients)) had been used as an educational matrix for a mathematic forecast and as a construction of a prevention algorithm for septic complications in primary THA and TKA. The study had shown 14 significant criteria which can influence the occurrence of surgical site infection in THA and TKA. 12-month testing period of the software in prospective research (467 cases) had shown a significant decrease rate of surgical site infection in comparison to retrospective research (decrease of 7.5% in the prospective cases and 4.1% - in retrospective).

Predictors of Successful Early Discharge for Total Hip and Knee Arthroplasty in Octogenarians

2021 ◽  
pp. 155633162110306
Author(s):  
Andrew B. Kay ◽  
Danielle Y. Ponzio ◽  
Courtney D. Bell ◽  
Fabio Orozco ◽  
Zachary D. Post ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Early Discharge ◽  
Readmission Rates ◽  
Patients Âgés ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
Student’S T ◽  
American Society ◽  
American Society Of Anesthesiologists

Background: Decreased length of stay after total joint arthroplasty (TJA) is becoming a more common way to contain healthcare costs and increase patient satisfaction. There is little evidence to support “early” discharge in elderly patients. Purpose: We sought to identify preoperative factors that correlated with early discharge (by postoperative day [POD] 1) in comparison to late discharge (after POD2) in octogenarians after TJA. Methods: In a retrospective cohort study from a single institution, we identified 482 patients ages 80 to 89 who underwent primary TJA from January 2014 to December 2017; 319 had total knee arthroplasty (TKA) and 163 had total hip arthroplasty (THA). Data collected included preoperative knee range of motion (ROM), demographics, and comorbidities; 90-day readmission and mortality rates were also evaluated. P values for continuous data were calculated using student’s t test and for categorical data using χ2 testing. Results: Of octogenarian patients, 30.9% were discharged by POD1. Early discharge was associated with being male, married, and nonsmoking, as well as having an American Society of Anesthesiologists (ASA) score of 2, independent preoperative ambulation, and a postoperative caregiver. Type of procedure (TKA vs THA), body mass index, laterality, preoperative range of motion (ROM) for TKA, and single vs multilevel home did not affect the probability of early discharge. Discharge on POD1 was not associated with increased 90-day readmission rates. There were no deaths. Conclusion: Early discharge for octogenarians can be successfully implemented in a select subset of patients without increasing 90-day readmission or death rates. There are multiple factors that predict successful early discharge.

scholarly journals The Effects of Depression and Anxiety on 90-day Readmission Rates After Total Hip and Knee Arthroplasty

2021 ◽  
Vol 10 ◽  
pp. 175-179
Author(s):  
Paul Knapp ◽  
James T. Layson ◽  
Waleed Mohammad ◽  
Natalie Pizzimenti ◽  
David C. Markel
Keyword(s):  
Knee Arthroplasty ◽  
Depression And Anxiety ◽  
Readmission Rates ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

scholarly journals Inflammatory blood parameters as prognostic factors for surgical site infection after primary hip or knee arthroplasty: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046027
Author(s):  
Petr Domecky ◽  
Anna Rejman Patkova ◽  
Katerina Mala-Ladova ◽  
Josef Maly
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Diagnostic Accuracy ◽  
Surgical Site Infection ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Blood Parameters ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Site Infection

IntroductionSurgical site infection (SSI) is a potential complication of surgical procedure. SSI after implant surgery is a disaster both for patients and surgeons. Although predictive tools for SSI are available, none of them estimate early infection based on inflammatory blood parameters. The inflammatory process can be measured using several parameters including interleukin-6, C reactive protein, neutrophil to lymphocyte ratio, white cell count, erythrocyte sedimentation rate or procalcitonin. This systematic review aims to determine whether inflammatory blood parameters could be used as significant predictive factors for SSI after primary hip or knee arthroplasty.Methods and analysisA systematic review of randomised controlled trials, cross-sectional studies, case–control studies and cohort studies, published in English, will be searched in the following electronic bibliographic databases: MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials and Web of Science. Studies performed in adult patients of all ages who underwent knee or hip arthroplasty, studies containing data on the risk/prognostic factors for preknee or postknee or hip arthroplasty SSI and studies with a minimum follow-up of 30 days after surgery will be included. A standardised form will be used to extract data from the included studies comprising study characteristics, participant characteristics, details of the intervention, study methodology and outcomes. Quality Assessment of Diagnostic Accuracy tool, second version, and Standards for Reporting of Diagnostic Accuracy Studies checklist will be used to assess risk of bias. Heterogeneity will be assessed using Cochran χ² statistic and I2 statistics where applicable. Grading of Recommendations Assessment, Development and Evaluation and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance will be used to report findings.Ethics and disseminationNo ethics approval is required. The findings will be disseminated at national and international scientific sessions, also to be published in a peer-reviewed journal.PROSPERO registration numberCRD42020147925.

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