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Demographics and surgery-related complications lead to 30-day readmission rates among knee arthroscopic procedures

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The study objectives were (1) to evaluate risk factors related to 30-day hospital readmissions after arthroscopic knee surgeries and (2) to determine the complications that may arise from surgery.

Methods

The American College of Surgeons National Surgical Quality Improvement Program database data from 2012 to 2017 were researched. Patients were identified using Current Procedural Terminology codes for knee arthroscopic procedures. Ordinal logistic fit regression and decision tree analysis were used to examine study objectives.

Results

There were 83,083 knee arthroscopic procedures between 2012 and 2017 obtained from the National Surgical Quality Improvement Program database. The overall readmission rate was 0.87%. The complication rates were highest for synovectomy and cartilage procedures, 1.6% and 1.3% respectively. A majority of readmissions were related to the procedure (71.1%) with wound complications being the primary reason (28.2%) followed by pulmonary embolism and deep vein thrombosis, 12.7% and 10.6%, respectively. Gender and body mass index were not significant factors and age over 65 years was an independent risk factor. Wound infection, deep vein thrombosis, and pulmonary embolism were the most prevalent complications.

Conclusion

Healthcare professionals have a unique opportunity to modify treatment plans based on patient risk factors. For patients who are at higher risk of inferior surgical outcomes, clinicians should carefully weigh risk factors when considering surgical and non-surgical approaches.

Level of evidence

III.

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Abbreviations

ACS:

American College of Surgeons

BMI:

Body mass index

CVA:

Cerebrovascular accident

COPD:

Chronic obstructive pulmonary disease

CPT:

Current procedural terminology

DVT:

Deep vein thrombosis

HIPAA:

Health insurance portability and accountability act

ICD:

International classification of diseases

JMP:

John's Macintosh project

NSQIP:

National surgical quality improvement program

SAS:

Statistical analysis system

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Acknowledgements

Disclosures

The American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

Author information

Authors and Affiliations

  1. Department of Health Administration, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224-2646, USA

    Cynthia Williams

  2. Department of Public Administration, School of Criminology, Criminal Justice and Public Administration, College of Liberal and Fine Arts, Tarleton State University, 10850 Texan Rider Dr., Rm # 336, Fort Worth, TX, 76036-9414, USA

    Matt T. Bagwell

  3. Department of Mathematics and Statistics, College of Arts and Sciences, University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224-2646, USA

    Michelle DeDeo

  4. Department of Orthopedic Surgery, University of Maryland, 110 S Paca St, Baltimore, MD, 21201, USA

    Alexandra Baker Lutz

  5. Department of Orthopedic Surgery, William Beaumont Hospital, Royal Oak, 3577 W.13 Mile Rd., Suite 402, Royal Oak, MI, 48073, USA

    M. Jordan Deal

  6. University of Central Florida College of Medicine, 6850 Lake Nona Blvd 32827, Orlando, FL, USA

    Bradley P. Richey

  7. AdventHealth Research Institute | Orthopedic Institute, 301 E Princeton St, Orlando, FL, 32804, USA

    Ibrahim M. Zeini

  8. Orlando Health Jewett Orthopedic Institute, 7243 Della Drive, Floor 2, Suite I, Orlando, FL, 32819, USA

    Benjamin Service

  9. Rothman Orthopaedic Institute Florida, 410 Lionel Way Suite 201, Davenport, FL, 33837, USA

    D. Harrison Youmans & Daryl C. Osbahr

Authors
  1. Cynthia Williams
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  2. Matt T. Bagwell
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  3. Michelle DeDeo
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Contributions

CW, MB, IZ, AB, JD, BR, and BS conceptualised, designed the study, and contributed to background and discussion sections. MD ran the statistical analysis and contributed to the findings and discussion sections. DY and DO contributed to the discussion sections. MB also copy edited the submitted manuscript and ensured the quality and content of each section for coherence and accuracy. CW led this team project.

Corresponding author

Correspondence to Matt T. Bagwell.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

No sources of funding for this study. No authors report relevant financial disclosures.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

This study utilised de-identified publicly available data, and therefore formal consent was not required.

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Appendices

Appendix A: Demographic decision tree

figure a

Appendix B: Patient characteristic (age and weight) decision tree

figure b

Appendix C: Pre-existing comorbid condition decision tree

figure c

Appendix D: Combined indicator decision tree

figure d

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Williams, C., Bagwell, M.T., DeDeo, M. et al. Demographics and surgery-related complications lead to 30-day readmission rates among knee arthroscopic procedures. Knee Surg Sports Traumatol Arthrosc 30, 2408–2418 (2022). https://doi.org/10.1007/s00167-022-06919-2

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  • DOI: https://doi.org/10.1007/s00167-022-06919-2

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