Revision TKA in ASC Associated with Decreased Costs, Readmissions vs. Inpatient Setting

Revision TKA in ASC Associated with Decreased Costs, Readmissions vs. Inpatient Setting

With decreased 30-day postoperative costs and 90-day readmission rates, revision total knee arthroplasty performed in the ASC may be preferred vs. an inpatient or a hospital-based outpatient setting, according to published results.

Researchers performed an observational cohort study of 6,515 patients (mean age, 60.8 years) who underwent revision TKA in an inpatient setting (n = 5,407; 83%), hospital-based outpatient setting (n =979; 15%) or ASC (n = 129; 2%) from 2018 to 2020. Outcomes included 30-day postoperative surgical costs, 90-day readmission rates and postoperative ED visits.

Revision TKA in the ASC was associated with decreased costs and readmissions. Image: Adobe Stock

Researchers found patients who underwent surgery in the inpatient setting had the highest 30-day postoperative costs vs. patients who underwent surgery in the ASC or hospital-based outpatient setting. They noted one-component revision was more common in the ASC (62%) and hospital-based outpatient setting (50.7%) compared with an inpatient setting (39.6%).

Readmission rates were 10.8% (n = 582) for the inpatient setting, 10.2% (n = 100) for the hospital-based outpatient setting and 1.6% (n = 2) for the ASC setting at 90 days postoperatively. In addition, the rate of ED visits was 16.5% (n = 890) for the inpatient setting, 14.3% (n = 140) for the hospital-based outpatient setting and 7.8% (n = 10) for the ASC setting at 90 days postoperatively.

“The ASC may be a suitable setting for simpler revisions performed for less severe indications and is associated with lower costs, 90-day readmissions and ED visit rates,” the researchers wrote in the study.