To evaluate the causes of 30-day readmissions after orthopedic trauma
surgery and classify them based on their relation to the index admission.
Retrospective chart review.
One large, academic, medical center.
Patients admitted to a large, academic, medical center for a traumatic fracture injury over a 9-year period.
Assignment of readmission classification
Main Outcome Measures:
Readmissions within 30 days of discharge were identified and classified into orthopedic complications
, medical complications
, and noncomplications. A χ2
test was performed to assess any difference in the proportion of readmissions between the hospital-reported readmission
rate and the orthopedic complication readmission
One thousand nine hundred fifty-five patients who were admitted between 2011 and 2018 for an acute orthopedic trauma
fracture injury were identified. Eighty-nine patients were readmitted within 30 days of discharge with an overall readmission
rate of 4.55%. Within the 30-day readmission
cohort, 30 (33.7%) were the direct result of orthopedic treatment complications
, 36 (40.4%) were unrelated medical conditions, and 23 (25.8%) were noncomplications. Thus, the readmission
rate directly due to orthopedic treatment complications
was 1.53%. A χ2
test of homogeneity revealed a statistically significant difference between the hospital-reported readmission
rate and the orthopedic-treatment complication readmission
The use of 30-day readmissions as a measure of hospital quality of care overreports the number of preventable readmissions and penalizes surgeons and hospitals for caring for patients with less optimal health.
Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.