Frequency of Readmission Among American Society of Anesthesia Classification after Total Hip and Total Knee Arthroplasty

Main Article Content

Hafeez ur Rehman Zahoor
Saad Iqbal
Muhammad Abdullah Sharif
Muhammad Hunain
Muhammad Anwar
Hammar Shahid


Background: With the aging population and the increasing prevalence of degenerative joint diseases, the need for total joint arthroplasty (TJA) has surged. The American Society of Anesthesiologists (ASA) Physical Status Classification System plays a pivotal role in preoperative evaluation, predicting the risk of postoperative complications and mortality. Understanding the impact of ASA classification on surgical outcomes can guide improvements in patient care and surgical planning.

Objective: This study aimed to investigate the relationship between ASA classification and the risk of postoperative readmission in patients undergoing total joint arthroplasty.

Methods: Conducted at a single urban medical center, this descriptive, non-randomized study involved 352 patients who underwent primary TJA due to osteoarthritis, rheumatoid arthritis, or avascular necrosis. Participants were assigned an ASA classification preoperatively. The primary outcome measured was readmission within three months post-surgery, with secondary outcomes including the incidence of complications such as deep vein thrombosis (DVT), pulmonary embolism, and surgical site infections. Data were analyzed using SPSS version 21, with significance set at p<0.05.

Results: Of the 352 participants, 165 (46.9%) were from rural areas, and 187 (53.1%) were from urban locations. The readmission rate was 6.8%, with ASA III and IV classifications showing significantly higher readmission rates (9.7% and 28.6%, respectively) compared to ASA I and II (1.8% and 4.4%). The most common reasons for readmission were chest infections (37.5%), followed by cardiac complications, pulmonary embolism, and neurological complications (20.8% each). The study found a significant correlation between higher ASA classification and increased readmission risk (p=0.021).

Conclusion: Higher ASA classifications are associated with a greater risk of postoperative readmission in patients undergoing total joint arthroplasty. These findings underscore the importance of comprehensive preoperative assessments and tailored postoperative care strategies to mitigate the risk of readmission, particularly in patients with higher ASA scores.

Article Details

How to Cite
Zahoor, H. ur R., Iqbal, S., Sharif, M. A., Hunain, M., Anwar, M., & Shahid, H. (2024). Frequency of Readmission Among American Society of Anesthesia Classification after Total Hip and Total Knee Arthroplasty. Journal of Health and Rehabilitation Research, 4(2), 227–232.
Author Biographies

Hafeez ur Rehman Zahoor, Liaquat National Hospital Karachi Pakistan.

Registrar, Orthopaedics Department, Liaquat National Hospital, Karachi, Pakistan.

Saad Iqbal, Patel Hospital Karachi Pakistan.

Registrar, Orthopaedic Department, Patel Hospital, Karachi, Pakistan.

Muhammad Abdullah Sharif, Beaumont Hospital

Registrar, Orthopaedic Department, Beaumont Hospital Ireland.

Muhammad Hunain, Shaheed Muhtarma Benazir Bhutto Institute of Trauma Karachi Pakistan.

Resident Medical Officer, Orthopaedic Surgery Department, Shaheed Muhtarma Benazir Bhutto Institute of Trauma, Karachi, Pakistan.

Muhammad Anwar, Liaquat National Hospital Karachi Pakistan.

Resident, Orthopaedics Surgery Department, Liaquat National Hospital, Karachi, Pakistan.

Hammar Shahid, The Aga Khan University Hospital Karachi Pakistan.

Resident, Department of Surgery, Section of Orthopedics, The Aga Khan University Hospital, Karachi, Pakistan.


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