Tuesday, April 29, 2014

Risk of readmission is associated with more comorbidity

Higher Charlson Comorbidity Index Scores are Associated With Readmission After Orthopaedic Surgery.

These authors sought to determine if Charlson Comorbidity Index (CCI) was correlated with the risk of  hospital readmission,  surgical site infection or other adverse events,  transfusion, or  mortality after orthopaedic surgery.

Of a total of 30,129 patients having orthopaedic surgeries performed between 2008 and 2011,
913 patients (3.0%) were readmitted within 30 days after discharge;
393 (1.4%) had adverse events occurred; 
417 (1.4%) had a surgical site infection develop; 
211 (0.7%) needed transfusions, and 
56 (0.2%) died within 30 days after surgery. 

Every point increase in CCI score added an additional 0.45% risk in readmission for patients undergoing arthroplasty. While it was  not associated with surgical site infection or other adverse surgical events, it was associated with the risk of transfusion and mortality. 

Comment: The patient's overall health is one of the major determinants of the outcome of surgery. As interest grows in bundled payment for elective surgery (that includes the risk of 90 day readmission), profiling of the risk of readmission will become increasingly important. We have posted previously on the importance of comorbidity


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