Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Preoperative Scale for Assessing TKA Readmission

J Bone Joint Surg Am; ePub 2017 Nov 1; Siracuse, et al

The Readmission After Total Knee Arthroplasty (RATKA) Scale, derived from patient data in the derivation cohort, was reliably able to explain readmission variability after TKA for patients in the validation cohort at a rate of >95%, according to a recent study. Discharge data on 433,638 patients from New York and California (derivation cohort) and 269,934 patients from Florida and Washington (validation cohort) who underwent TKA were collected from the State Inpatient Database (2006 to 2011). Demographic and clinical characteristics of patients were abstracted and analyzed to develop the Readmission After Total Knee Arthroplasty (RATKA) Scale. Researchers found:

  • Overall 30-day readmission rates in the derivation and validation cohorts were 5.11% and 4.98%, respectively.
  • The following factors (used to create the RATKA Scale) were significantly associated with increased 30-day readmission rates in the derivation cohort: age of 41 to 50 years, age of 71 to 80 years, age of 81 to 90 years, male sex, African-American race, “other” race/ethnicity, Medicaid payer, Medicare payer, anemia, chronic obstructive pulmonary disease, coagulopathy, congestive heart failure, diabetes, fluid and electrolyte disorder, hypertension, liver disease, renal failure, and rheumatoid arthritis.


Siracuse BL, Ippolito JA, Gibson PD, Ohman-Strickland PA, Beebe KS. A preoperative scale for determining surgical readmission risk after total knee arthroplasty. [Published online ahead of print November 1, 2017]. J Bone Joint Surg Am. doi:10.2106/JBJS.16.01043.

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