Purpose
To determine the rate of and risk factors for 30-day unplanned admissions following
hip arthroscopy in a U.S. population.
Methods
Patients undergoing hip arthroscopy were identified in the American College of Surgeons
National Surgical Quality Improvement Program database using validated Current Procedural
Terminology and International Classification of Diseases, Ninth Revision and Tenth Revision codes. Patient demographics, comorbidities, preoperative laboratory values, surgical
details, and postoperative outcomes were compared between patients with unplanned
admissions and those without. Univariate analysis comparing study cohorts was performed
using 2-tailed Student t tests with Levene's test for equality of variance or χ2/Fisher exact tests as appropriate. Using variables that were significant in the univariate
analysis, we created Cox proportional hazard models to identify independent predictors
for unplanned admission.
Results
A total of 1931 cases of hip arthroscopy were identified. There were 18 cases of unplanned
admissions within 30 days of index procedure (0.9%). The median time to unplanned
admission was 14.5 days (interquartile range: 3.875-25.125 days). The most common
reasons for admission were surgical-site infection (11.1%), wound complications (11.1%),
and thromboembolic events (11.1%). There were 4 patients who required reoperation
(22.2%). There were 7 cases (39.0%) that were readmitted for reasons unrelated to
the index hip arthroscopy procedure. Multivariate analysis identified increasing body
mass index, chronic corticosteroid use, and perioperative blood transfusion as factors
independently associated with increased risk for unplanned admission.
Conclusions
There exists a low incidence of 30-day unplanned admission, predominantly secondary
to surgical-site infections, wound complications, and thromboembolic events. Independent
risk factors for unplanned admission include greater body mass index, chronic corticosteroid
use, and perioperative transfusions.
Level of Evidence
Level III Retrospective Cohort Study.
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Article info
Publication history
Accepted:
June 13,
2019
Received:
December 16,
2018
Footnotes
See commentary on page 3278
The authors report the following potential conflict of interest or source of funding: R.C.M. reports other from Reflexion, other from Zimmer, personal fees from KNG Health Consulting, and personal fees from Stryker, outside the submitted work. S.J.N. reports other from Allosource, Arthrex, Athletico, DJ Orthopaedics, Livantec, Miomed, Smith & Nephew, Stryker, and Ossur, outside the submitted work. M.J.S. reports personal fees from Stryker Corporation, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
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© 2019 by the Arthroscopy Association of North America
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Access this article on ScienceDirectLinked Article
- Editorial Commentary: Readmission Rate After Hip Arthroscopy: Is There a Cause for Concern?ArthroscopyVol. 35Issue 12
- PreviewReadmission after hip arthroscopic surgery is an undesired and unusual event. The causes may range from wound-related issues, deep infection, increasing pain, complications of surgery, to medical events. It adds to the economic burden of the procedure and causes unnecessary anguish to the patients and indeed clinicians. It is also one of the less-studied areas of hip arthroscopic surgery because of its rarity. There would be benefit in being able to identify the risk factors of readmission such that pre-emptive measures can be put in place to prevent or indeed counsel the patients before the surgery.
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