Risk factors for 30-day readmission following hip arthroscopy

Matthew J. Hartwell*, Allison M. Morgan, Daniel J. Johnson, Richard W. Nicolay, Ryan S. Selley, Vehniah Kristin Tjong, Michael Allen Terry

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: Hip arthroscopy is known to be safe with low rates of postoperative complications. The purpose of this study is to evaluate hip arthroscopy cases in a national surgical database to identify risk factors associated with readmission. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2012 to 2016 for current procedural terminology billing codes related to hip arthroscopy. International Classification of Diseases diagnostic codes were used to exclude cases involving infection, fracture, or open procedures. Univariate and multivariate analyses were performed to identify risk factors associated with 30-day readmission. Results: 1493 patients were identified who had undergone hip arthroscopy. The most common procedures were labral resection or chondroplasty (n = 589, 39.5%) and femoroplasty (n = 527, 35.3%). The 30-day complication rate was 1.7% and the most common complications following the procedure were bleeding (n = 12, 0.8%) superficial infections (n = 5, 0.3%), and returning to the operating room (n = 4, 0.3%). The 30-day readmission rate was 1.3%. On multivariate analysis, hypertension requiring anti-hypertensive medication (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.4–8.7) and chronic corticosteroid or immunosuppressant use (OR 7.2; 95% CI 1.9–26.7) were identified as independent risk factors for readmission. There was no difference in complication rates when hip arthroscopy was performed with isolated femoroplasty (n = 340), isolated acetabuloplasty (n = 103), both (n = 187) or neither (n = 863). Conclusion: These findings confirm that the 30-day readmission (1.3%) and complication rate (1.7%) are low for isolated hip arthroscopy procedures; however, hypertension and chronic steroid use are independent risk factors for readmission. Level of evidence: Retrospective comparative study, Level III.

Original languageEnglish (US)
JournalKnee Surgery, Sports Traumatology, Arthroscopy
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Arthroscopy
Hip
Multivariate Analysis
Odds Ratio
Current Procedural Terminology
Databases
Confidence Intervals
Hypertension
Open Fractures
International Classification of Diseases
Operating Rooms
Immunosuppressive Agents
Quality Improvement
Infection
Antihypertensive Agents
Adrenal Cortex Hormones
Retrospective Studies
Steroids
Hemorrhage

Keywords

  • Co-morbidities
  • Demographics
  • Hip arthroscopy
  • Readmission
  • Risk factors

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Hartwell, Matthew J. ; Morgan, Allison M. ; Johnson, Daniel J. ; Nicolay, Richard W. ; Selley, Ryan S. ; Tjong, Vehniah Kristin ; Terry, Michael Allen. / Risk factors for 30-day readmission following hip arthroscopy. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2019.
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title = "Risk factors for 30-day readmission following hip arthroscopy",
abstract = "Purpose: Hip arthroscopy is known to be safe with low rates of postoperative complications. The purpose of this study is to evaluate hip arthroscopy cases in a national surgical database to identify risk factors associated with readmission. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2012 to 2016 for current procedural terminology billing codes related to hip arthroscopy. International Classification of Diseases diagnostic codes were used to exclude cases involving infection, fracture, or open procedures. Univariate and multivariate analyses were performed to identify risk factors associated with 30-day readmission. Results: 1493 patients were identified who had undergone hip arthroscopy. The most common procedures were labral resection or chondroplasty (n = 589, 39.5{\%}) and femoroplasty (n = 527, 35.3{\%}). The 30-day complication rate was 1.7{\%} and the most common complications following the procedure were bleeding (n = 12, 0.8{\%}) superficial infections (n = 5, 0.3{\%}), and returning to the operating room (n = 4, 0.3{\%}). The 30-day readmission rate was 1.3{\%}. On multivariate analysis, hypertension requiring anti-hypertensive medication (odds ratio [OR], 3.5; 95{\%} confidence interval [CI], 1.4–8.7) and chronic corticosteroid or immunosuppressant use (OR 7.2; 95{\%} CI 1.9–26.7) were identified as independent risk factors for readmission. There was no difference in complication rates when hip arthroscopy was performed with isolated femoroplasty (n = 340), isolated acetabuloplasty (n = 103), both (n = 187) or neither (n = 863). Conclusion: These findings confirm that the 30-day readmission (1.3{\%}) and complication rate (1.7{\%}) are low for isolated hip arthroscopy procedures; however, hypertension and chronic steroid use are independent risk factors for readmission. Level of evidence: Retrospective comparative study, Level III.",
keywords = "Co-morbidities, Demographics, Hip arthroscopy, Readmission, Risk factors",
author = "Hartwell, {Matthew J.} and Morgan, {Allison M.} and Johnson, {Daniel J.} and Nicolay, {Richard W.} and Selley, {Ryan S.} and Tjong, {Vehniah Kristin} and Terry, {Michael Allen}",
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Risk factors for 30-day readmission following hip arthroscopy. / Hartwell, Matthew J.; Morgan, Allison M.; Johnson, Daniel J.; Nicolay, Richard W.; Selley, Ryan S.; Tjong, Vehniah Kristin; Terry, Michael Allen.

In: Knee Surgery, Sports Traumatology, Arthroscopy, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors for 30-day readmission following hip arthroscopy

AU - Hartwell, Matthew J.

AU - Morgan, Allison M.

AU - Johnson, Daniel J.

AU - Nicolay, Richard W.

AU - Selley, Ryan S.

AU - Tjong, Vehniah Kristin

AU - Terry, Michael Allen

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: Hip arthroscopy is known to be safe with low rates of postoperative complications. The purpose of this study is to evaluate hip arthroscopy cases in a national surgical database to identify risk factors associated with readmission. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2012 to 2016 for current procedural terminology billing codes related to hip arthroscopy. International Classification of Diseases diagnostic codes were used to exclude cases involving infection, fracture, or open procedures. Univariate and multivariate analyses were performed to identify risk factors associated with 30-day readmission. Results: 1493 patients were identified who had undergone hip arthroscopy. The most common procedures were labral resection or chondroplasty (n = 589, 39.5%) and femoroplasty (n = 527, 35.3%). The 30-day complication rate was 1.7% and the most common complications following the procedure were bleeding (n = 12, 0.8%) superficial infections (n = 5, 0.3%), and returning to the operating room (n = 4, 0.3%). The 30-day readmission rate was 1.3%. On multivariate analysis, hypertension requiring anti-hypertensive medication (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.4–8.7) and chronic corticosteroid or immunosuppressant use (OR 7.2; 95% CI 1.9–26.7) were identified as independent risk factors for readmission. There was no difference in complication rates when hip arthroscopy was performed with isolated femoroplasty (n = 340), isolated acetabuloplasty (n = 103), both (n = 187) or neither (n = 863). Conclusion: These findings confirm that the 30-day readmission (1.3%) and complication rate (1.7%) are low for isolated hip arthroscopy procedures; however, hypertension and chronic steroid use are independent risk factors for readmission. Level of evidence: Retrospective comparative study, Level III.

AB - Purpose: Hip arthroscopy is known to be safe with low rates of postoperative complications. The purpose of this study is to evaluate hip arthroscopy cases in a national surgical database to identify risk factors associated with readmission. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2012 to 2016 for current procedural terminology billing codes related to hip arthroscopy. International Classification of Diseases diagnostic codes were used to exclude cases involving infection, fracture, or open procedures. Univariate and multivariate analyses were performed to identify risk factors associated with 30-day readmission. Results: 1493 patients were identified who had undergone hip arthroscopy. The most common procedures were labral resection or chondroplasty (n = 589, 39.5%) and femoroplasty (n = 527, 35.3%). The 30-day complication rate was 1.7% and the most common complications following the procedure were bleeding (n = 12, 0.8%) superficial infections (n = 5, 0.3%), and returning to the operating room (n = 4, 0.3%). The 30-day readmission rate was 1.3%. On multivariate analysis, hypertension requiring anti-hypertensive medication (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.4–8.7) and chronic corticosteroid or immunosuppressant use (OR 7.2; 95% CI 1.9–26.7) were identified as independent risk factors for readmission. There was no difference in complication rates when hip arthroscopy was performed with isolated femoroplasty (n = 340), isolated acetabuloplasty (n = 103), both (n = 187) or neither (n = 863). Conclusion: These findings confirm that the 30-day readmission (1.3%) and complication rate (1.7%) are low for isolated hip arthroscopy procedures; however, hypertension and chronic steroid use are independent risk factors for readmission. Level of evidence: Retrospective comparative study, Level III.

KW - Co-morbidities

KW - Demographics

KW - Hip arthroscopy

KW - Readmission

KW - Risk factors

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