ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #643

 

Risk Factors for 30-Day Readmission Following Hip Arthroscopy

Matthew J. Hartwell, MD, Chicago, IL UNITED STATES
Allison M Morgan, BA, Chicago, Illinois UNITED STATES
Vehniah K. Tjong, MD, FRCSC, Chicago, IL UNITED STATES
Richard W. Nicolay, MD, Chicago, IL UNITED STATES
Ryan S. Selley, MD, Chicago, IL UNITED STATES
Michael Terry, MD, Chicago, IL UNITED STATES
Vehniah K. Tjong, MD, FRCSC, Chicago, IL UNITED STATES

Northwestern University, Chicago, IL, UNITED STATES

FDA Status Not Applicable

Summary

Utilizing a national surgical database, this study confirms that the 30-day readmission (1.34%) and complication rate (1.67%) is low for isolated hip arthroscopy procedures, however hypertension requiring anti-hypertensive medication and chronic steroid or immunosuppressant use for a chronic condition are independent risk factors for readmission.

Abstract

Purpose

The utilization of hip arthroscopy has dramatically increased over the past decade and is known to be safe with low rates of major post-operative complications. The purpose of this study is to evaluate hip arthroscopy cases in a national surgical database to identify risk factors associated with readmission following this routine outpatient orthopaedic procedure.

Methods

The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried from 2012 to 2016 for current procedural terminology (CPT) billing codes related to hip arthroscopy. International Classification of Diseases, Ninth and Tenth Editions (ICD-9 and ICD-10) diagnostic codes were then used to exclude cases which involved infection, fracture, or an open procedure. Patients were subsequently reviewed for readmission within 30 days. Univariate and multivariate analyses were then performed to identify risk factors associated with 30-day readmission.

Results

We identified 1,493 patients who had undergone hip arthroscopy. The most common primary billing codes were labral resection or chondroplasty (n=589, 39.5%) and femoroplasty (n=527, 35.3%). The overall 30-day complication rate was 1.67% and the most common complications following the procedure were bleeding, (n=12, 0.80%), superficial infections (n=5, 0.33%), and returning to the operating room (n=4, 0.27%). The 30-day readmission rate was 1.34%. On multivariate analysis, hypertension requiring medication (odds ratio [OR], 3.45; 95% confidence interval [CI], 1.37-8.68) and chronic corticosteroid or immunosuppressant use for a chronic condition within 30 days prior to the procedure (OR, 7.16; 95% CI, 1.92-26.70) were identified as independent risk factors for readmission. Primary procedures with the highest rates of readmission were labral repairs (n=4, 2.33% of performed procedures) and labral resection (n=12, 2.04% of performed cases). There was no difference in complication rates when hip arthroscopy was performed with isolated femoroplasty (n=340), isolated acetabuloplasty (n=103), both (n=187) or neither (n=863).

Conclusion

These findings confirm that the 30-day readmission (1.34%) and complication rate (1.67%) is low for isolated hip arthroscopy procedures, however hypertension and chronic steroid use are independent risk factors for readmission.