Evidence map›Paper›PMID 34906233›Full record

ArticlePerioperative medicine (London, England)2021

Readmissions after elective orthopedic surgery in a comprehensive co-management care system-a retrospective analysis.

Felix Rohrer, David Haddenbruch, Hubert Noetzli, Brigitta Gahl, Andreas Limacher, Tanja Hermann, Jan Bruegger

Open access · goldAbstract read
In one paragraph

Article in Perioperative medicine (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Felix Rohrer *Department of Internal Medicine, Sonnenhofspital, 3006, Bern, Switzerland. felix.rohrer@lindenhofgruppe.ch.ORCID http://orcid.org/0000-0002-3874-5599
David Haddenbruch *University of Bern, 3012, Bern, Switzerland.
Hubert NoetzliUniversity of Bern, 3012, Bern, Switzerland.
Brigitta GahlClinical Trials Unit (CTU) Bern, University of Bern, 3012, Bern, Switzerland.
Andreas LimacherClinical Trials Unit (CTU) Bern, University of Bern, 3012, Bern, Switzerland.
Tanja HermannStiftung Lindenhof, Campus SLB, Swiss Institute for Translational and Entrepreneurial Medicine, 3010, Bern, Switzerland.
Jan BrueggerDepartment of Internal Medicine, Sonnenhofspital, 3006, Bern, Switzerland.
University of Bern · CHUniversity Hospital of Lausanne · CHUniversity of Zurich · CH

Funding

the Fonds fuer Lehre und Forschung Lindenhof 14-11-F and 16-04-F
6 · The paper itself

Abstract

backgroundNo surgical intervention is without risk. Readmissions and reoperations after elective orthopedic surgery are common and are also stressful for the patient. It has been shown that a comprehensive ortho-medical co-management model decreases readmission rates in older patients suffering from hip fracture; but it is still unclear if this also applies to elective orthopedic surgery. The aim of the current study was to determine the proportion of unplanned readmissions or returns to operating room (for any reason) across a broad elective orthopedic population within 90 days after elective surgery. All cases took place in a tertiary care center using co-management care and were also assessed for risk factors leading to readmission or unplanned return to operating room (UROR).

methodsIn this observational study, 1295 patients undergoing elective orthopedic surgery between 2015 and 2017 at a tertiary care center in Switzerland were investigated. The proportion of reoperations and readmissions within 90 days was measured, and possible risk factors for reoperation or readmission were identified using logistic regression.

resultsIn our cohort, 3.2% (42 of 1295 patients) had an UROR or readmission. Sixteen patients were readmitted without requiring further surgery-nine of which due to medical and seven to surgical reasons. Patient-related factors associated with UROR and readmission were older age (67 vs. 60 years; p = 0.014), and American Society of Anesthesiologists physical status (ASA PS) score ≥ 3 (43% vs. 18%; p < 0.001). Surgery-related factors were: implantation of foreign material (62% vs. 33%; p < 0.001), duration of operation (76 min. vs. 60 min; p < 0.001), and spine surgery (57% vs. 17%; p < 0.001). Notably, only spine surgery was also found to be independent risk factor.

conclusionRates of UROR during initial hospitalization and readmission were lower in the current study than described in the literature. However, several comorbidities and surgery-related risk factors were found to be associated with these events. Although no surgery is without risk, known threats should be reduced and every effort undertaken to minimize complications in high-risk populations. Further prospective controlled research is needed to investigate the potential benefits of a co-management model in elective orthopedic surgery.

Indexed as

Co-management modelOrthopedic surgeryReadmissionUnplanned return to operating room

Identifiers

PMID34906233
PMCPMC8672479
OpenAlexW4200618035

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.