Readmission and Reoperation Following Carpometacarpal Arthroplasty

Kenny Ling; Richelle Fassler; Jane Burgan; David E Komatsu; Edward D Wang

doi:10.1016/j.jhsg.2023.06.014

Readmission and Reoperation Following Carpometacarpal Arthroplasty

J Hand Surg Glob Online. 2023 Jul 27;5(5):661-666. doi: 10.1016/j.jhsg.2023.06.014. eCollection 2023 Sep.

Authors

Kenny Ling¹, Richelle Fassler², Jane Burgan², David E Komatsu¹, Edward D Wang²

Affiliations

¹ Department of Orthopaedics, Stony Brook University, Stony Brook, NY.
² Renaissance School of Medicine at Stony Brook University, Stony Brook, NY.

Abstract

Purpose: Carpometacarpal (CMC) arthroplasty is an effective surgical treatment for osteoarthritis of the CMC joint. Risk factors for readmission and reoperation have been studied for other joint arthroplasty procedures but have not yet been studied for CMC arthroplasty. The purpose of this study was to identify patient demographics and comorbidities associated with 30-day readmission and 30-day reoperation after CMC arthroplasty.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all records of patients who underwent CMC arthroplasty between 2015 and 2020. Variables collected in this study included patient demographics, comorbidities, surgical characteristics, and 30-day postsurgical complication data. Multivariate logistic regression was used to identify independent associations between patient characteristics and readmission and reoperation after CMC arthroplasty.

Results: In total, 6,432 records were included in this study: 34 (0.5%) were readmitted within 30 days, and 27 (0.4%) underwent reoperation within 30 days. Compared with the non-readmission cohort, the readmission cohort was significantly associated with higher rates of age ≥ 75 years (P = .003), body mass index (BMI) ≥ 40 kg/m² (P = .005), American Society of Anesthesiologists classification (ASA) ≥ 3; P < .001), insulin-dependent diabetes (P = .016), and chronic obstructive pulmonary disease (COPD; P = .009). Compared with the non-reoperation cohort, the reoperation cohort was significantly associated with higher rates of age ≥ 75 years (P = .003), BMI ≥ 40 kg/m² (P = .005), ASA ≥ 3 (P < .001), insulin-dependent diabetes (p = .016), and COPD (P = .009).

Conclusion: The clinically significant predictors for 30-day readmission and 30-reoperation after CMC arthroplasty were age ≥ 75 years, BMI ≥ 40 kg/m², ASA ≥ 3, insulin-dependent diabetes, and COPD. Of these risk factors, age and BMI were identified as independent predictors for 30-day readmission. A better understanding of presurgical risk factors for postsurgical complications may help surgeons with risk stratification and optimization of outcomes.

Type of study/level of evidence: Prognostic III.

Keywords: Carpometacarpal arthroplasty; Hand; Osteoarthritis; Readmission; Reoperation.