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Unplanned Admissions Following Hip Arthroscopy: Incidence and Risk Factors

      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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      Linked Article

      • Editorial Commentary: Readmission Rate After Hip Arthroscopy: Is There a Cause for Concern?
        ArthroscopyVol. 35Issue 12
        • Preview
          Readmission 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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