Westermann et al identfied risk factors for 30-day unplanned readmission of a patient following shoulder or knee arthroscopy. These can help to identify a patient who may be at greater risk. The authors are from the University of Iowa.
Patient selection: knee or shoulder arthroscopy
Outcome: 30-day unplanned readmission
Frequency of outcome: 0.92%
Most readmissions were for wound-related complications.
Risk factors for unplanned readmission from the multivariate logistic regression model:
(1) age > 80 years of age (odds ratio 3.5)
(2) ASA class 3 or 4 (odds ratios 1.9 and 4.2 respectively)
(3) chronic steroid use (odds ratio 3.3)
Many of the patients had high levels of comorbidity (dyspnea, COPD, cancer, diabetes, etc).
Recommendations for surgeons:
(1) careful perioperative wound management including site preparation
(2) venous thromboembolism prophylaxis
(3) pain management
Special attention should be paid to patients with one or more risk factors.
