From the Faculty of Medicine, Dalhousie University, Halifax, N.S. (Jennings); the Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, N.S. (Al-Hubaishi, Dunbar); the Department of Surgery, Dalhousie University, Halifax, N.S. (Douglas); Performance and Analytics, Quality and System Performance, Nova Scotia Health, Halifax, N.S. (Nemeth).
From the Faculty of Medicine, Dalhousie University, Halifax, N.S. (Jennings); the Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, N.S. (Al-Hubaishi, Dunbar); the Department of Surgery, Dalhousie University, Halifax, N.S. (Douglas); Performance and Analytics, Quality and System Performance, Nova Scotia Health, Halifax, N.S. (Nemeth)
Can J Surg. 2024 Nov 6;67(6):E356-E362. doi: 10.1503/cjs.008824. Print 2024 Nov-Dec.
Postoperative visits to the emergency department (ED) generate additional costs on health care systems and consume already limited resources. We sought to determine the rate and reasons why patients who underwent primary knee arthroplasty returned to the ED within 90 days of postoperative discharge, which could guide the development of preventative measures.
We identified patients who underwent primary knee arthroplasty at 2 hospitals in Nova Scotia, Canada, between April 2021 and March 2022 and who had an ED visit within 90 days of postoperative discharge. We reviewed data for timing and reason for ED visits.
Of 687 patients who had primary knee arthroplasty surgeries, 145 (21.1%) patients visited the ED within 90 days of postoperative discharge. Most visits occurred in the early postoperative period, predominantly for surgical reasons (94.7% within 7 days) and shifting toward medical reasons over time. Pain was the most common surgical reason for ED visits (15.9%), followed by swelling (9.7%), and hematoma drainage (9.7%).
Understanding the reasons for postoperative ED visits after knee arthroplasty is important in developing strategies to reduce ED overcrowding and improve patient outcomes. Implementing targeted interventions, such as enhanced pain management and patient education, may help alleviate the burden on EDs, reduce costs, and improve overall health care delivery for patients undergoing knee arthroplasty.
术后到急诊科（ED）就诊会给医疗系统增加额外成本，并消耗已经有限的资源。我们试图确定在术后出院后 90 天内接受初次膝关节置换术的患者返回 ED 的比率和原因，这可以为制定预防措施提供指导。
我们确定了 2021 年 4 月至 2022 年 3 月期间在加拿大新斯科舍省的 2 家医院接受初次膝关节置换术且在术后出院后 90 天内到 ED 就诊的患者。我们回顾了 ED 就诊的时间和原因的数据。
在 687 例接受初次膝关节置换术的患者中，有 145 例（21.1%）在术后出院后 90 天内到 ED 就诊。大多数就诊发生在术后早期，主要是手术原因（7 天内 94.7%），随着时间的推移逐渐转向医疗原因。疼痛是 ED 就诊最常见的手术原因（15.9%），其次是肿胀（9.7%）和血肿引流（9.7%）。
了解膝关节置换术后 ED 就诊的原因对于制定减少 ED 拥堵和改善患者结局的策略很重要。实施有针对性的干预措施，如增强疼痛管理和患者教育，可能有助于减轻 ED 的负担，降低成本，并改善接受膝关节置换术的患者的整体医疗服务提供。
