Parkinson’s Disease Patients Face Higher 90-Day Readmission, Reoperation, and Infection Risk Following Total Knee Arthroplasty

TL;DR

Parkinson’s disease patients are more likely to be readmitted after knee replacement surgery, often due to infections and needing more procedures.

Contribution

This study identifies higher readmission and complication risks for Parkinson’s patients after TKA using a large national database.

Findings

PD patients had a 13.0% readmission rate compared to 7.3% in non-PD patients.

Infection-related readmissions were more common in PD patients (4.1% vs 2.2%).

Readmission costs were higher for PD patients ($63,023 vs $48,855).

Abstract

Parkinson’s disease (PD) is an increasingly common comorbidity in patients undergoing total knee arthroplasty (TKA), yet its impact on readmissions remains poorly defined.

Using the Nationwide Readmissions Database 2020-2022, we identified elective, primary TKA cases. Patients with oncologic diagnoses, COVID-19-related admissions, acute fractures, and contralateral knee arthroplasty were excluded. Only the first readmission within 90 days was analyzed. Propensity score matching (1:1) was performed for demographics, comorbidities, hospital factors, and primary payer. The primary outcome was 90-day readmission. Secondary outcomes included infection-related readmissions, surgical procedures during readmission, readmission length of stay, readmission costs, and in-hospital mortality.

After matching, 7286 patients were included (3675 PD vs 3611 non-PD). PD patients had a significantly higher 90-day readmission rate (13.0% vs 7.3%; P < .01). Infection-related readmissions (4.1% vs 2.2%; P < .01) and surgical procedures during readmission (7.5% vs 4.1%; P < .01) were more frequent in PD patients. Readmission length of stay was longer (5.9 vs 4.1 days; P < .01), and readmission costs were higher ($63,023 vs $48,855; P < .01). In-hospital mortality during readmission was also higher in PD patients (0.3% vs 0.1%; P < .01).

PD is associated with a significantly higher risk of 90-day readmission following TKA, with readmissions frequently involving infection-related complications and surgical intervention. These findings highlight the importance of tailored perioperative care and enhanced postdischarge monitoring in this vulnerable population.

Level III.

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