Key result
The presence of two or more preoperative modifiable risk factors increased the odds of surgical site infections, and three or more increased the odds of 30-day readmission after arthroplasty.
Why the study?
Preoperative optimization of modifiable risk factors for arthroplasty patients is critical, motivating evaluation of the correlation between seven modifiable risk factors and postoperative adverse outcomes after THA and TKA.
Does the presence of multiple modifiable risk factors increase the risk of 30-day readmissions and 90-day major complications in patients undergoing total hip and knee arthroplasty?
Observational (n=996,014)
Yes
Does the presence of multiple modifiable risk factors increase the risk of 30-day readmissions and 90-day major complications in patients undergoing total hip and knee arthroplasty?
The presence of multiple modifiable risk factors prior to total hip or knee arthroplasty significantly increases the odds of postoperative complications such as surgical site infections and 30-day readmissions.
BACKGROUND: Preoperative optimization of modifiable risk factors (MRFs) for arthroplasty patients is a critical aspect of predicting and improving postoperative outcomes. This study evaluates the correlation between seven MRFs and postoperative adverse outcomes after total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: A retrospective review of primary TKA and THA were identified from a large medical claims database. Patients were categorized based on the number of MRF diagnoses present before surgery (anemia, malnutrition, obesity, opioid abuse/dependence, mental illness, type 2 diabetes mellitus, and tobacco use), from zero to seven. Adverse outcomes evaluated were surgical site infections (SSIs), venous thromboembolic events (VTEs), and readmissions. RESULTS: Of the patient records queried (THA = 303,857; TKA = 692,157), two or more MRFs were identified in 41% of THA patients and 47% of TKA patients. Patients with two or more MRFs were at an increased odds of developing an SSI, and patients with three or more MRFs had increase odds of having a 30-day hospital readmission. CONCLUSIONS: This study adds to the compendium of literature, which promotes preoperative optimization of MRFs in arthroplasty patients to decrease the risks of 90-day postoperative complications.
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Kostyun et al. (2025) conducted an observational in Total hip and knee arthroplasty (n=996,014). Multiple modifiable risk factors (MRFs) vs. Fewer modifiable risk factors was evaluated on Surgical site infections (SSIs), venous thromboembolic events (VTEs), and 30-day hospital readmissions. The presence of two or more preoperative modifiable risk factors increased the odds of surgical site infections, and three or more increased the odds of 30-day readmission after arthroplasty.
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