Discharge destination after revision total joint arthroplasty: an analysis of post-discharge outcomes and placement risk factors

Abstract Background Given the rising incidence of revision total joint replacement (RJR), bundled payments will likely be applied to RJR in the near future. This study aimed to compare post-discharge adverse events by discharge destination, identify risk factors for discharge placement, and stratify RJR patients based on these risk factors to identify the most appropriate discharge destination. Methods Patients that underwent revision total hip or knee replacement from 2011-2013 were identified in the ACS NSQIP database. Analysis of risk factors was assessed using preoperative and intraoperative variables. Results 9,973 RJR patients from 2011 to 2013 were included for analysis. The most common discharge destination included home (66%), skilled nursing facility (SNF) (23%), and inpatient rehabilitation facility (IRF) (11%). Bivariate analysis revealed higher rate of post-discharge 30-day severe adverse events (SAEs) (6.1% vs. 4.1%, p