Incidence and safety profile of outpatient unicompartmental knee arthroplasty.
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures
/ statistics & numerical data
Arthroplasty, Replacement, Knee
/ methods
Blood Transfusion
/ statistics & numerical data
Female
Humans
Male
Middle Aged
Patient Readmission
/ statistics & numerical data
Pneumonia
/ epidemiology
Postoperative Complications
Retrospective Studies
Risk
United States
/ epidemiology
Complications
Medial
Outpatient surgery
Readmission
Unicompartmental knee arthroplasty
Journal
The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
11
10
2018
accepted:
02
02
2019
pubmed:
12
3
2019
medline:
24
10
2019
entrez:
12
3
2019
Statut:
ppublish
Résumé
Outpatient surgery is an increasingly attractive option for patients undergoing procedures with established, acceptable risk profiles. Benefits of outpatient surgery include cost savings, enhanced patient experience and improved resource allocation at busy hospitals. The purpose of this study was to compare 90-day complication and readmission rates for patients undergoing unicompartmental knee arthroplasty (UKA) in the outpatient as opposed to the inpatient setting. Patients who underwent UKA (CPT code 27446) between 2007 and 2016 were retrospectively selected from a national private insurance database. Patients were defined as ambulatory if their coded location of procedure was in an ambulatory surgery center or as an in-hospital outpatient. Postoperative complications were identified using the Reportable Center for Medicare Services (CMS) Complication Measures. Risks of complications were compared between the inpatient and outpatient cohorts using multivariate logistic regression controlling for age, gender, and comorbidities. 2600 patients undergoing ambulatory UKA and 5084 patients undergoing inpatient UKA were identified. The percentage of UKA procedures performed on an outpatient basis significantly increased over the course of the study (14.5% to 58.1%, p < 0.001). After adjusting for age, gender, and comorbidities, ambulatory surgery was found to be associated with a decreased risk of postoperative transfusion (OR 0.28; p < 0.001) and pneumonia (OR 0.23; p = 0.008) and there was a trend towards decreased 90-day readmission risk (OR = 0.83; p = 0.062). Ambulatory discharge following UKA is increasing in popularity, does not increase risk for perioperative complications or readmission, and may even portend a safer post-operative course.
Sections du résumé
BACKGROUND
BACKGROUND
Outpatient surgery is an increasingly attractive option for patients undergoing procedures with established, acceptable risk profiles. Benefits of outpatient surgery include cost savings, enhanced patient experience and improved resource allocation at busy hospitals. The purpose of this study was to compare 90-day complication and readmission rates for patients undergoing unicompartmental knee arthroplasty (UKA) in the outpatient as opposed to the inpatient setting.
METHODS
METHODS
Patients who underwent UKA (CPT code 27446) between 2007 and 2016 were retrospectively selected from a national private insurance database. Patients were defined as ambulatory if their coded location of procedure was in an ambulatory surgery center or as an in-hospital outpatient. Postoperative complications were identified using the Reportable Center for Medicare Services (CMS) Complication Measures. Risks of complications were compared between the inpatient and outpatient cohorts using multivariate logistic regression controlling for age, gender, and comorbidities.
RESULTS
RESULTS
2600 patients undergoing ambulatory UKA and 5084 patients undergoing inpatient UKA were identified. The percentage of UKA procedures performed on an outpatient basis significantly increased over the course of the study (14.5% to 58.1%, p < 0.001). After adjusting for age, gender, and comorbidities, ambulatory surgery was found to be associated with a decreased risk of postoperative transfusion (OR 0.28; p < 0.001) and pneumonia (OR 0.23; p = 0.008) and there was a trend towards decreased 90-day readmission risk (OR = 0.83; p = 0.062).
CONCLUSION
CONCLUSIONS
Ambulatory discharge following UKA is increasing in popularity, does not increase risk for perioperative complications or readmission, and may even portend a safer post-operative course.
Identifiants
pubmed: 30853161
pii: S0968-0160(18)30896-2
doi: 10.1016/j.knee.2019.02.002
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
708-713Informations de copyright
Copyright © 2019. Published by Elsevier B.V.