Malnutrition, smoking history increase risks following outpatient joint replacement: 3 study insights

Written by  Jessica Kim Cohen | Wednesday, 11 January 2017 19:55
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A study in Journal of Arthroplasty investigated what risk factors are associated with complications following outpatient total joint arthroplasty.

The researchers used the American College of Surgeons-National Surgical Quality Improvement Program database to identify 169,406 patients who underwent total joint arthroplasty, 1,220 of whom received the outpatient procedure. They determined independent risk factors of poor short-term outcomes based on an analysis of demographic variables and medical comorbidities.


Here's what you need to know:


1. Overall, the outpatient group had an 8 percent complication rate, while the inpatient group had a 16 percent complication rate.


2. Outpatient total joint arthroplasty was not associated with an increased risk of readmission or reoperation; the outpatient procedure also decreased risk for overall complications.


3. When only considering the outpatient procedure, patients aged more than 70 years, those with malnutrition, cardiac history, smoking history or diabetes mellitus were at higher risk for readmission and complications.


"With the resources available in a hospital setting, outpatient TJA may be a safe option, but only in select, healthier patients," the researchers concluded. "Care should be taken to extrapolate these results to an outpatient facility, where complications may be more difficult to manage."



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