Objective To examine if an underlying diagnosis of rheumatoid arthritis (RA) or osteoarthritis (OA) impacts the 90-day readmission rates after total hip or knee arthroplasty (THA or TKA). 33 815 had OA. Comparing RA and OA there were: 73% and 61% women; 45% and 70% Caucasians; and the mean age was lower 61 vs. 67 years (p<0.001). Respective crude 90-day readmission rates were 8.5% and 6.7%. The adjusted probability of 90-day time readmission improved from yr to yr for RA in comparison to OA individuals from 0.89 (95% Atazanavir sulfate (BMS-232632-05) CI 0.46 in '09 2009 to at least one 1.34 (95% CI 0.69 this year 2010 to at least one 1.74 (95% CI 1.16 in 2011. Both most common readmission factors had been: joint prosthesis disease (10.2%) and septicemia (10.2%) in RA; joint prosthesis disease (5.7%) and additional postoperative disease (5.1%) in OA. Conclusions RA is a risk element for 90-day time readmission after major THA or TKA. An increasing threat of readmissions mentioned in RA in 2011 can be concerning and shows further research should examine the reason why for this raising trend. Keywords: Total hip alternative total knee replacement unit readmission osteoarthritis arthritis rheumatoid arthroplasty joint alternative diagnosis risk element Intro Total joint arthroplasty can be an elective efficacious medical option for individuals with end-stage joint disease (1). Medical center readmission after arthroplasty can be an undesired event with 90-day time readmission rates which range from 7-8% after major total hip or total knee arthroplasty (THA TKA) (2-4). Post-arthroplasty complications such as surgical site infections procedure-related complications sepsis thromboembolic and cardiovascular complications are responsible for the majority of readmissions (2 5 6 Osteoarthritis (OA) and rheumatoid arthritis (RA) are the two most common reasons for patients to undergo TKA or THA. Recent studies have reported that perioperative complications after THA and TKA were higher in patients with an underlying diagnosis of RA compared to OA (7-9). Biologics a Rabbit Polyclonal to NDUFA3. new class of medication are now used commonly for the treatment of RA which may increase the risk of skin and soft tissue infections and thus impact the readmission rates in RA (10 11 Given the differences in disease pathophysiology and treatment an important question is whether underlying diagnosis is a risk factor for post-arthroplasty readmissions. To our knowledge only one Taiwanese study including patients who under went TKA between 2002 and 2004 examined if the underlying diagnosis for arthroplasty was a predictor of hospital readmission after index arthroplasty. In that study 768 patients with RA undergoing TKA had higher 90-day readmission (14.2% vs.11.3%) compared to 3 840 age- and gender-matched patients with OA (12). There is a lack of contemporary data from U.S. or Europe in this area which are needed given the differences in rates of treatment with biologics baseline infection rates and the risk of various infections between different populations (13-15). Our main study objectives were to use a representative U.S. sample to assess (1) whether RA was an independent risk factor for 90-day readmission rate after primary THA or TKA (2) the causes for readmission and (3) whether the causes of readmission differed between RA and OA. Strategies Study strategies and email address details are described as suggested in Atazanavir sulfate (BMS-232632-05) Atazanavir sulfate (BMS-232632-05) the Conditioning of Confirming in Observational research in Epidemiology (STROBE) declaration (16). Study Style DATABASES and Patient Test A retrospective evaluation of the cohort of individuals that underwent THA or TKA between 01/01/2009 and 12/31/2011 was carried out. Patients were determined using a healthcare program Total Joint Alternative Registry (TJRR). The health care system addresses over 9 million people in 7 US physical areas. Information on the TJRR data collection methods structure and involvement have already been previously reported (17 18 In short the TJRR gathers information at the idea of treatment by cosmetic surgeons or other devoted companies using both paper and digital data capture equipment. Additionally TJRR data are gathered from other directories (like the digital Atazanavir sulfate (BMS-232632-05) medical information) using digital screening algorithms. The info repository for the registry can be a SQL.