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Systematic Reviews
Published in: Systematic Reviews 1/2019

Open Access 01-12-2019 | Protocol

Patient-related risk factors for unplanned 30-day readmission following total knee arthroplasty: a protocol for a systematic review and meta-analysis

Authors: Daniel Gould, Michelle Dowsey, Tim Spelman, Imkyeong Jo, Wassif Kabir, Jason Trieu, Peter Choong

Published in: Systematic Reviews | Issue 1/2019

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Abstract

Background

Osteoarthritis is a debilitating condition as well as a growing global health problem, and total knee arthroplasty is an effective treatment for advanced stages of disease. Unplanned 30-day hospital readmission is an indicator of complications, which is a significant financial burden on healthcare systems. The objective is to perform a systematic review of patient-related factors associated with unplanned 30-day readmission following total knee arthroplasty. This information will inform future strategies to improve health outcomes after knee arthroplasty surgery.

Methods

MEDLINE and EMBASE will be systematically searched using a comprehensive search strategy. Studies of higher quality than case series will be included, in order to optimise the quality of the findings of this review. We will include studies reporting on patient-related risk factors for unplanned 30-day readmission following primary or revision total knee arthroplasty for any indication. Case series will be excluded, as will studies reporting exclusively on intraoperative, clinician, hospital, and health system risk factors. The reference lists of selected papers will then be screened for any additional literature. Two reviewers will independently apply stringent eligibility criteria to titles, abstracts, and full texts of studies identified in the literature search. They will then extract data from the final list of selected papers according to an agreed-upon taxonomy and vocabulary of the data to be extracted. Assessment of risk of bias and quality of evidence will then take place. Finally, the effect size of each identified risk factor will be determined; meta-analysis will be performed where adequate data is available.

Discussion

The findings of this review and subsequent meta-analysis will aid clinicians as they seek to understand the risk factors for 30-day readmission following total knee arthroplasty. Clinicians and patients will be able to use this information to align expectations of the postoperative course, which will enhance the recovery process, and aid in the development of strategies to mitigate identified risks. Another purpose of this review is to assist policy-makers in developing quality indicators for care and provide insights into the drivers of health costs.

Systematic review registration

PROSPERO CRD42019118154.
Appendix
Available only for authorised users
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Metadata
Title
Patient-related risk factors for unplanned 30-day readmission following total knee arthroplasty: a protocol for a systematic review and meta-analysis
Authors
Daniel Gould
Michelle Dowsey
Tim Spelman
Imkyeong Jo
Wassif Kabir
Jason Trieu
Peter Choong
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-019-1140-3

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