Patient selection: TKA or THA, age 60 to 100 years
Parameters:
(1) joint replaced
(2) age in years
(3) insurance type
(4) smoking status
(5) ASA status
(6) cardiac arrhythmia
(7) depression
(8) liver disease
(9) diabetes complicated
(10) drug abuse
(11) hypertension
(12) neurologic disease
(13) peripheral vascular disease
(14) pulmonary circulation disease
(15) postoperative BUN in mg/dL
(16) postoperative hemoglobin in g/dL
(17) duration of surgery in minutes
points for age 60 to 70 =
= 35.56 - (0.508 * (age))
points for age 70 to 100 =
= (0.01547 * ((age)^2)) - (0.7758 * (age)) - 21.73
points for postoperative BUN =
= (1.0625 * (BUN)) - 10.625
points for hemoglobin =
= (0.1306 * ((hemoglobin)^2)) - (5.278 * (hemoglobin)) + 52.44
points for duration of surgery 20 to 120 minutes =
= (-0.003443 * ((minutes)^2)) + (1.173 * (score)) - 23.03
points for duration of surgery from 120 to 320 minutes =
= (0.1594 * (minutes)) + 49.08
|
Parameter
|
Finding
|
Points
|
|
joint replaced
|
knee
|
0
|
|
|
hip
|
14.8
|
|
insurance type
|
private
|
0
|
|
|
medicare or other
|
11.9
|
|
smoking status
|
never
|
0
|
|
|
current
|
11
|
|
|
former
|
11
|
|
ASA status
|
ASA 1
|
0
|
|
|
ASA 2
|
13.4
|
|
|
ASA 3
|
26.3
|
|
|
ASA 4
|
39.8
|
|
cardiac arrhythmias
|
no
|
0
|
|
|
yes
|
9.3
|
|
depression
|
no
|
0
|
|
|
yes
|
15.5
|
|
liver disease
|
no
|
0
|
|
|
yes
|
16.9
|
|
complicated diabetes
|
no
|
0
|
|
|
yes
|
22,6
|
|
drug abuse
|
no
|
0
|
|
|
yes
|
76.7
|
|
hypertension
|
no
|
0
|
|
|
yes
|
10.6
|
|
neurologic disease
|
no
|
0
|
|
|
yes
|
20.7
|
|
peripheral vascular disease
|
no
|
0
|
|
|
yes
|
22.9
|
|
pulmonary circulation disease
|
no
|
0
|
|
|
yes
|
24.9
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 574.9
• The higher the score the greater the risk of readmission.
value of X =
= (0.02489 * (score)) - 6.199
