Bryce T Hrudka, Andrew Fuqua, Jenny Nguyen, Janice Bonsu, Bridger Rodoni, Ayomide M Ayeni, Jacob Wilson, Ajay Premkumar
{"title":"无菌翻修全膝关节置换术后再入院的费用趋势分析。","authors":"Bryce T Hrudka, Andrew Fuqua, Jenny Nguyen, Janice Bonsu, Bridger Rodoni, Ayomide M Ayeni, Jacob Wilson, Ajay Premkumar","doi":"10.1016/j.arth.2025.03.051","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>A rise in total knee arthroplasty (TKA) volume has led to an increased incidence of aseptic revision TKA (rTKA), resulting in significant associated healthcare costs. This study evaluated the economic impact and clinical factors associated with readmission following aseptic rTKA, aiming to identify key drivers of cost and risk factors for readmission.</p><p><strong>Methods: </strong>This retrospective analysis used data from a large national database from January 1, 2009, to June 30, 2022. Patients undergoing aseptic rTKA were identified via CPT (Current Procedural Terminology) codes. Readmissions within 90 days postoperatively were analyzed. Baseline characteristics, comorbidities, and readmission costs were compared, and significant risk factors for readmission were identified. Of 34,144 aseptic rTKA patients, 1,953 (5.7%) were readmitted within 90 days (56.1% medical, 29.2% surgical, 14.8% unknown).</p><p><strong>Results: </strong>The median cost of all readmissions was $25,181. Readmissions requiring reoperation had a higher cost (median $40,524 versus $20,907, P < 0.001). Among readmissions for surgical complications, periprosthetic joint infection was the most common cause (36.3%) and was associated with the greatest cost (median $38,104). The most common medical causes of readmission were rehabilitative care, ischemic cardiac events, and acute kidney injury. Significant risk factors for all-cause readmission included men, index revision for periprosthetic fracture, and comorbidities, including diabetes, coronary artery disease, renal disease, and congestive heart failure.</p><p><strong>Conclusion: </strong>Readmission after aseptic rTKA results in a major economic burden to the healthcare system, particularly in readmission pertaining to surgical complications and requiring reoperation. This study highlights the need for targeted strategies aimed at effectively reducing the rate of and costs associated with readmission post-rTKA with a goal of cost containment and improved patient outcomes.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characterizing the Cost Trends of Readmissions after Aseptic Revision Total Knee Arthroplasty.\",\"authors\":\"Bryce T Hrudka, Andrew Fuqua, Jenny Nguyen, Janice Bonsu, Bridger Rodoni, Ayomide M Ayeni, Jacob Wilson, Ajay Premkumar\",\"doi\":\"10.1016/j.arth.2025.03.051\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>A rise in total knee arthroplasty (TKA) volume has led to an increased incidence of aseptic revision TKA (rTKA), resulting in significant associated healthcare costs. This study evaluated the economic impact and clinical factors associated with readmission following aseptic rTKA, aiming to identify key drivers of cost and risk factors for readmission.</p><p><strong>Methods: </strong>This retrospective analysis used data from a large national database from January 1, 2009, to June 30, 2022. Patients undergoing aseptic rTKA were identified via CPT (Current Procedural Terminology) codes. Readmissions within 90 days postoperatively were analyzed. Baseline characteristics, comorbidities, and readmission costs were compared, and significant risk factors for readmission were identified. Of 34,144 aseptic rTKA patients, 1,953 (5.7%) were readmitted within 90 days (56.1% medical, 29.2% surgical, 14.8% unknown).</p><p><strong>Results: </strong>The median cost of all readmissions was $25,181. Readmissions requiring reoperation had a higher cost (median $40,524 versus $20,907, P < 0.001). Among readmissions for surgical complications, periprosthetic joint infection was the most common cause (36.3%) and was associated with the greatest cost (median $38,104). The most common medical causes of readmission were rehabilitative care, ischemic cardiac events, and acute kidney injury. Significant risk factors for all-cause readmission included men, index revision for periprosthetic fracture, and comorbidities, including diabetes, coronary artery disease, renal disease, and congestive heart failure.</p><p><strong>Conclusion: </strong>Readmission after aseptic rTKA results in a major economic burden to the healthcare system, particularly in readmission pertaining to surgical complications and requiring reoperation. This study highlights the need for targeted strategies aimed at effectively reducing the rate of and costs associated with readmission post-rTKA with a goal of cost containment and improved patient outcomes.</p>\",\"PeriodicalId\":51077,\"journal\":{\"name\":\"Journal of Arthroplasty\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-03-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Arthroplasty\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.arth.2025.03.051\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arthroplasty","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arth.2025.03.051","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Characterizing the Cost Trends of Readmissions after Aseptic Revision Total Knee Arthroplasty.
Introduction: A rise in total knee arthroplasty (TKA) volume has led to an increased incidence of aseptic revision TKA (rTKA), resulting in significant associated healthcare costs. This study evaluated the economic impact and clinical factors associated with readmission following aseptic rTKA, aiming to identify key drivers of cost and risk factors for readmission.
Methods: This retrospective analysis used data from a large national database from January 1, 2009, to June 30, 2022. Patients undergoing aseptic rTKA were identified via CPT (Current Procedural Terminology) codes. Readmissions within 90 days postoperatively were analyzed. Baseline characteristics, comorbidities, and readmission costs were compared, and significant risk factors for readmission were identified. Of 34,144 aseptic rTKA patients, 1,953 (5.7%) were readmitted within 90 days (56.1% medical, 29.2% surgical, 14.8% unknown).
Results: The median cost of all readmissions was $25,181. Readmissions requiring reoperation had a higher cost (median $40,524 versus $20,907, P < 0.001). Among readmissions for surgical complications, periprosthetic joint infection was the most common cause (36.3%) and was associated with the greatest cost (median $38,104). The most common medical causes of readmission were rehabilitative care, ischemic cardiac events, and acute kidney injury. Significant risk factors for all-cause readmission included men, index revision for periprosthetic fracture, and comorbidities, including diabetes, coronary artery disease, renal disease, and congestive heart failure.
Conclusion: Readmission after aseptic rTKA results in a major economic burden to the healthcare system, particularly in readmission pertaining to surgical complications and requiring reoperation. This study highlights the need for targeted strategies aimed at effectively reducing the rate of and costs associated with readmission post-rTKA with a goal of cost containment and improved patient outcomes.
期刊介绍：
The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.
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