Factors influencing 30-day readmission rate and return to theatre rate due to surgical causes following primary total hip arthroplasty

影响初次全髋关节置换术后30天内再入院率和因手术原因再次手术率的因素

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Abstract

BACKGROUND: Total Hip Arthroplasty (THA) is a widely performed, cost-effective procedure for degenerative joint disease, with demand increasing due to an ageing population. While THA generally has favourable outcomes, 30-day readmission and return to theatre (RTT) rates are key to surgical success and healthcare efficiency. This study evaluates these rates, identifying primary causes and associated risk factors. METHODS: A retrospective analysis of 18,233 primary elective THAs performed between January 2008 and December 2022 at a single institution was conducted. Data were extracted using Office of Population Censuses and Surveys (OPCS) procedure codes. Patients undergoing THA for acute trauma, or revision surgeries were excluded. 30-day Surgical readmissions and RTT cases were analysed separately. Demographic data, comorbidities, and length of stay were recorded. RESULTS: The 30-day surgical readmission rate was 1.40 % (255 patients), with an RTT rate of 0.76 % (140 patients). Wound hematoma was the leading cause of readmission (63.9 %) and RTT (65.7 %), followed by dislocation (11.8 % readmission; 19.1 % RTT) and periprosthetic fractures (7.4 % readmission; 11.0 % RTT). Readmission rates peaked in 2019 at 23.2 per 1000 surgeries. CONCLUSION: Wound complications and dislocations are the leading causes of early postoperative readmission and RTT. Enhanced perioperative care, optimized surgical techniques, and stricter wound management protocols may help reduce these rates and improve patient outcomes.

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