Two-Day Length of Stay is Not Inferior to 3 Days in Total Knee Arthroplasty with Regards to 30-Day Readmissions

Stefano A Bini; Maria C S Inacio; Guy Cafri

doi:10.1016/j.arth.2014.12.006

Two-Day Length of Stay is Not Inferior to 3 Days in Total Knee Arthroplasty with Regards to 30-Day Readmissions

J Arthroplasty. 2015 May;30(5):733-8. doi: 10.1016/j.arth.2014.12.006. Epub 2014 Dec 5.

Authors

Stefano A Bini¹, Maria C S Inacio², Guy Cafri²

Affiliations

¹ Department of Orthopaedic Surgery, The Permanente Medical Group, 280 Macarthur Blvd, Oakland, CA.
² Surgical Outcomes and Analysis, Kaiser Permanente, 8954 Rio San Diego Drive, Suite 406, San Diego, CA.

PMID: 25550213
DOI: 10.1016/j.arth.2014.12.006

Abstract

The impact of a shortened length of stay (LOS) following total knee arthroplasty (TKA) on the risk of readmission is not well documented despite recent trends towards shorter hospitalization. We retrospectively compared the adjusted risk of 30-day readmission following TKA between patients with 2-, 3- and 4-day LOS using current postoperative care protocols. A total of 23,655 consecutive primary, unilateral TKAs operated between 01/01/2009 and 12/31/2011 were studied retrospectively using non-inferiority testing. The main outcome was 30-day readmission. Two-day LOS decreased the odds of readmission by a factor of 0.96, with an upper bound one-sided 95% confidence interval of 1.10. After adjusting for other variables, LOS of 2 days is not inferior to 3 days with respect to the risk of 30-day readmission.

Keywords: length of stay; non-inferiority; readmission; risk factors; total knee arthroplasty.

MeSH terms

Aged
Aged, 80 and over
Algorithms
Arthroplasty, Replacement, Knee / statistics & numerical data*
Female
Hospitalization / statistics & numerical data*
Humans
Length of Stay*
Male
Middle Aged
Patient Readmission*
Prospective Studies
Retrospective Studies
Treatment Outcome