Do preoperative PROMIS scores independently predict 90-day readmission following primary total knee arthroplasty?

Anirudh Buddhiraju, Linwei Tony Chen, Michelle Shimizu

Research output: Journal article publicationJournal articleAcademic researchpeer-review

Abstract

Introduction: The rising demand for total knee arthroplasty (TKA) is expected to increase the total number of TKA-related readmissions, presenting significant public health and economic burden. With the increasing use of Patient-Reported Outcomes Measurement Information System (PROMIS) scores to inform clinical decision-making, this study aimed to investigate whether preoperative PROMIS scores are predictive of 90-day readmissions following primary TKA. Materials and methods: We retrospectively reviewed a consecutive series of 10,196 patients with preoperative PROMIS scores who underwent primary TKA. Two comparison groups, readmissions (n = 79; 3.6%) and non-readmissions (n = 2091; 96.4%) were established. Univariate and multivariate logistic regression analyses were then performed with readmission as the outcome variable to determine whether preoperative PROMIS scores could predict 90-day readmission. Results: The study cohort consisted of 2170 patients overall. Non-white patients (OR = 3.53, 95% CI [1.16, 10.71], p = 0.026) and patients with cardiovascular or cerebrovascular disease (CVD) (OR = 1.66, 95% CI [1.01, 2.71], p = 0.042) were found to have significantly higher odds of 90-day readmission after TKA. Preoperative PROMIS-PF10a (p = 0.25), PROMIS-GPH (p = 0.38), and PROMIS-GMH (p = 0.07) scores were not significantly associated with 90-day readmission. Conclusion: This study demonstrates that preoperative PROMIS scores may not be used to predict 90-day readmission following primary TKA. Non-white patients and patients with CVD are 3.53 and 1.66 times more likely to be readmitted, highlighting existing racial disparities and medical comorbidities contributing to readmission in patients undergoing TKA.

Original languageEnglish
Pages (from-to)861-867
Number of pages7
JournalArchives of Orthopaedic and Trauma Surgery
Volume144
Issue number2
DOIs
Publication statusPublished - 1 Feb 2024

Keywords

  • PROMIS
  • PROMs
  • Physical function
  • Readmissions
  • TKA
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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