Risk Factors for Readmission Following Same-Day Discharge in Primary Total Hip Arthroplasty

Area of Science:

• Orthopaedic Surgery
• Patient Safety
• Health Services Research

Background:

• Same-day discharge (SDD) for primary total hip arthroplasty (THA) is increasingly common and safe for selected patients.
• Limited data exist on how patient-specific risk factors for readmission differ between SDD and non-same-day discharge (NSDD) cohorts.
• Identifying differential risk factor impacts can refine SDD selection criteria and enhance postoperative safety.

Purpose of the Study:

• To compare the magnitude of influence of specific patient risk factors on 90-day readmission in SDD versus NSDD cohorts undergoing primary THA.
• To identify risk factors that disproportionately affect readmission rates in the SDD THA population.

Main Methods:

• Retrospective cohort study of 11,245 primary elective THA patients (2017-2024).
• Patients categorized into SDD (n=2,318) and NSDD (n=8,927) groups.
• Multivariable logistic regression analyzed predictors of 90-day orthopaedic-related readmission, with effect sizes compared between cohorts.

Main Results:

• SDD patients had lower readmission rates (0.8% vs 2.1%, P < 0.001).
• In SDD, smoking (OR 13.98) and older age (OR 1.13) strongly predicted readmission; women were protected.
• Smoking and age showed significantly stronger associations with readmission in SDD vs NSDD patients (z=4.34, P<0.001 and z=3.65, P<0.001, respectively).

Conclusions:

• While SDD after THA demonstrates low overall readmission, smoking and advanced age present disproportionately higher risks.
• These factors warrant careful consideration in preoperative counseling and individualized SDD decision-making.
• Absolute readmission rates remain low, supporting continued use of SDD in appropriately selected patients.