Key result
Preoperative EKG, MRSA, and urine cultures linked to ~68% lower 90-day readmission after joint replacement.
Why the study?
Practice patterns of preoperative tests before total hip or knee replacement and their association with postoperative outcomes needed to be described and examined.
Do preoperative tests reduce 90-day all-cause readmissions and length of stay in adults undergoing total hip or knee replacement?
Population
55,099 adults undergoing THR or TKR with a preoperative outpatient visit
Comparison
Utilization of EKG, chest X-ray, and seven preoperative laboratory tests
Design
Retrospective cohort study
Follow-up
90 days
Authors
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MRSA screening, EKG, and urine culture were associated with fewer readmissions; hypothesis-generating and requires prospective confirmation before changing practice.
Cohort (n=55,099)
Do preoperative tests reduce 90-day all-cause readmissions and length of stay in adults undergoing total hip or knee replacement?
Odds Ratio: 0.32 (95% CI 0.16–0.65)
Absolute Event Rate: 5.62% vs 8.87%
p-value: p=<0.0001
Preoperative MRSA testing, urine culture, and EKG are associated with a lower likelihood of 90-day all-cause readmissions in patients undergoing total hip or knee replacement.
Hasan et al. (2022) conducted a cohort in Total Hip and Knee Replacement (n=55,099). Preoperative testing (EKG, MRSA screening, urine culture) vs. No specific preoperative test was evaluated on 90-day all-cause readmission (OR 0.32, 95% CI 0.16-0.65, p=<0.0001). Preoperative EKG, MRSA screening, and urine culture were associated with a 55% to 69% reduction in the odds of 90-day all-cause readmission among patients undergoing total hip or knee replacement.
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