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Risk of 30-day readmission after knee or hip replacement in rheumatoid arthritis and osteoarthritis by non-Medicare and Medicare payer status

The Journal of Rheumatology Feb 03, 2022

Findings demonstrate a higher 30-day rehospitalization risk following total knee replacement (TKR) and total hip replacement (THR) procedures in rheumatoid arthritis (RA) patients, compared with patients with osteoarthritis (OA), irrespective of payer type. No difference in infections, postoperative complications, and cardiac events was found but there was a significant difference in venous thromboembolism (VTE) as the principal diagnosis of rehospitalization.

  • The Nationwide Readmission Database (2010–2014) was used to define an index hospitalization as an elective hospitalization with a principal procedure of THR or TKR among adults aged ≥ 18 years.

  • Of 2,190,745 index hospitalizations, 3.53% had a 30-day rehospitalization.

  • A higher adjusted risk of rehospitalization after TKR (OR 1.11) and THR (OR 1.39) was present in RA patients.

  • In terms of rates of infections, cardiac events, or postoperative complications leading to the rehospitalization, there was no difference between patients with RA and OA.

  • Following TKR, a lower VTE risk (OR 0.58) was observed in RA patients with Medicare, whereas those with RA were found to have a greater VTE risk (OR 2.41) post-THR.

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