Purpose: Provided that total hip arthroplasties (THA) are some of the most common surgical procedures performed, there is a necessity to understand all factors that contribute to risks of adverse outcomes postoperatively and to find solutions to avoid these events with preventive measures. This retrospective cohort study sought to assess differences in (1) postoperative complication rates, (2) readmission rates and reasons, and (3) demographic variables that contribute to readmissions based on discharge destination within the first 30 days after a THA.

Methods: Patients undergoing THA (27130) between 2015 and 2020 were extracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database based on procedural codes. Propensity score matching was then employed to reduce selection bias, and Chi-square tests and one-way analysis of variance (ANOVA) were performed. Multivariable analysis was then used to look for other factors associated with readmission risk.

Results: 219,960 patients were identified with 189,841 discharged to home, 19,355 to a skilled nursing facility (SNF), and 10,764 to a rehabilitation facility. The rehabilitation and SNF cohorts both had greater rates of readmission (4.56 % home vs. 6.88 % SNF vs. 6.90 % rehabilitation, P<0.001) and any adverse event (AAE, 9.02 % vs. 18 % vs. 21.3 %, P<0.001) after matching. Older age, longer operative time, American Society of Anesthesiologists (ASA) classification four, chronic obstructive pulmonary disease (COPD), bleeding disorders, steroid use, and smoking were associated with an increased risk of readmission after THA.

Conclusion: Overall, THAs were shown to have low postoperative complications and readmissions in all patient populations despite differences in discharge destination which continues to demonstrate the safety and validity of this often elective procedure. However, the statistically significant risk of complications and readmissions in addition to the higher costs associated should be accounted for when considering patient discharges to a non-home facility.

Keywords: “Discharge destination”; “NSQIP”; “Postoperative readmissions”; “Total hip arthroplasty”.

© 2024 The Authors.

目的： 鉴于全髋关节置换术（THA）是常见的手术程序之一，有必要了解所有影响术后不良结果风险的因素，并找到通过预防措施避免这些事件的解决方案。这项回顾性队列研究旨在评估在初次接受THA后的30天内，根据出院目的地的不同，术后并发症率、再入院率和原因以及与再入院相关的其他人口统计变量之间的差异。

方法： 从美国外科医师学会国家手术质量改进计划（ACS-NSQIP）数据库中提取了2015年至2020年间接受THA的患者数据（共27,130例），基于程序代码进行筛选。然后使用倾向性评分匹配来减少选择偏差，并进行了卡方检验和单因素方差分析（ANOVA）。随后，利用多变量分析查找与再入院风险相关的其他因素。

结果： 共识别出219,960名患者，其中189,841人出院回家，19,355人转至专业护理机构（SNF），10,764人进入康复中心。在匹配后，康复和SNF组的再入院率更高（家庭出院：4.56%，SNF出院：6.88%，康复出院：6.90%；P

结论： 总的来说，尽管出院目的地不同，但所有患者群体的THA术后并发症和再入院率都很低，这继续证明了这种经常选择性的手术的安全性和有效性。然而，在考虑将患者转至非家庭机构时，应考虑到统计上显著的并发症和再入院风险以及更高的成本。

关键词： “出院目的地”；“NSQIP”；“术后再入院”；“全髋关节置换术”。