Smolle Maria A, Fischerauer Stefan, Vukic Ines, Wenzl Florian A, Leitner Lukas, Leithner Andreas, Sadoghi Patrick
Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
Federal Ministry Republic of Austria, Social Affairs, Health, Care and Consumer Protection, Vienna, Austria.
J Arthroplasty. 2025 Feb;40(2):301-309.e3. doi: 10.1016/j.arth.2024.08.027. Epub 2024 Aug 29.
The primary aim of this study was to assess 30-day and 1-year rates for unplanned readmission due to implant-associated complications following total hip (THA) or total knee arthroplasty (TKA) in Austria. Secondary endpoints were reasons for readmission and differences in revision risk depending on demographics and hospital size.
Data on patients receiving THA (n = 18,508) or TKA (n = 15,884) in orthopaedic and trauma units across Austria within a 1-year period (January 2021 to December 2021) were retrieved from a government-maintained database. The absolute and relative frequencies of unplanned readmissions were calculated. Risk factors for 30-day and 1-year readmission following THA or TKA due to implant-associated complications were investigated.
The 30-day and 1-year readmission rates for any implant-associated complication were 1.0% (339 of 34,392) and 3.0% (1,024 of 34,392), respectively. Relative to the overall readmission rate for any complication at 30 days (n = 1,952) and 1 year (n = 12,109), readmission rates for implant-associated complications were 17.4 and 8.5%, respectively. The 30-day readmission rates were higher in THA (1.2%) than TKA patients (0.8%; P = 0.001), while it was the opposite at 1 year (THA, 2.7%; TKA, 3.3%; P < 0.001). Mechanical complications (554 of 1,024) were the most common reason for 1-year readmission. Prolonged length of in-hospital stay independently associated with increased 1-year readmission risk in THA and TKA patients. Treatment at large-sized hospitals was associated with a higher 1-year readmission risk in TKA patients.
The 30-day and 1-year readmission rates for implant-associated complications following THA or TKA in Austria are lower than reported in other countries, with similar risk factors and reasons for readmission. Considering that almost 20% of unplanned hospital readmissions following total joint arthroplasty are attributable to implant-associated complications, optimization of in-hospital and postdischarge medical care for these patients is warranted.
本研究的主要目的是评估奥地利全髋关节置换术（THA）或全膝关节置换术（TKA）后因植入物相关并发症导致的30天和1年非计划再入院率。次要终点是再入院原因以及根据人口统计学和医院规模划分的翻修风险差异。
从一个政府维护的数据库中检索了奥地利骨科和创伤科在1年期间（2021年1月至2021年12月）接受THA（n = 18,508）或TKA（n = 15,884）的患者数据。计算了非计划再入院的绝对和相对频率。研究了THA或TKA后因植入物相关并发症导致30天和1年再入院的危险因素。
任何植入物相关并发症的30天和1年再入院率分别为1.0%（34,392例中的339例）和3.0%（34,392例中的1,024例）。相对于任何并发症在30天（n = 1,952）和1年（n = 12,109）时的总体再入院率，植入物相关并发症的再入院率分别为17.4%和8.5%。THA患者的30天再入院率（1.2%）高于TKA患者（0.8%；P = 0.001），而在1年时情况相反（THA为2.7%，TKA为3.3%；P < 0.001）。机械并发症（1,024例中的554例）是1年再入院的最常见原因。THA和TKA患者住院时间延长与1年再入院风险增加独立相关。大型医院的治疗与TKA患者1年再入院风险较高相关。
奥地利THA或TKA后植入物相关并发症的30天和1年再入院率低于其他国家报道的水平，且再入院的危险因素和原因相似。考虑到全关节置换术后近20%的非计划住院再入院归因于植入物相关并发症，对这些患者进行院内和出院后医疗护理的优化是必要的。
