Appendix 2. Summary of criteria used for evaluating readmissions

Reasons for orthopaedic/technical readmission / Sources/guidelines used to determine if potentially preventable readmission / Brief summary of criteria used for determining if any appropriate
Alcohol withdrawal / DSM-V[2]. / CAGE criteria[2]
Appendicitis / Cope’s early diagnoses of acute abdomen[11] / Abdominal pain, fever, elevated WBC
Atrial fibrillation / European Society of Cardiology (ESC) Guidelines for the management of atrial fibrillation[4] / Diagnoses based on EKG and pulse examination in individuals older than 65 years
Cellulitis / No consensus objective criteria available / No consensus objective criteria available
Chest pain, not otherwise specified / No consensus objective criteria available / No consensus objective criteria available
Cholelithiasis / Cope’s early diagnoses of acute abdomen[11] / Abdominal pain, fever, elevated WBC, history of cholelithiasis
Clostridium difficile infection / American Society for Gastroenterology[13] / Elevated WBC, loose stool
Dehydration / No consensus objective criteria available / No consensus objective criteria available
Dislocation / Lewinneket al.[6] / Prosthesis size, alignment, and offset were appropriate on postoperative radiographs
Diverticulosis / Ad hoc practice guidelines from the American Society for Gastroenterology[12] / Subjective abdominal pain, elevated WBC, history of diverticular disease
Hematoma / Limited objective criteria available [8] / Appropriate deep vein thrombosis prophylaxis intensity
Ileus / No consensus objective criteria available / No consensus objective criteria available
Joint infection / Musculoskeletal Infection Society[9], SCIP[14] / No breaches of sterility, prophylactic antibiotic administration, appropriate MRSA screening
Myocardial infarction / NSQIP®[1]SCIP[14] / Preoperative EKGs, postoperative continuation of beta blockers, antiplatelet agents and statins
Nausea / No consensus objective criteria available / No objective criteria available
Nephrolithiasis / The American Urological Association
Nephrolithiasis Clinical Guidelines Panel[10] / Colicky pain, dysuria, elevated WBC, history of nephrolithiasis
Pain control / No consensus objective criteria available / No consensus objective criteria available
Periprosthetic fracture / Limited consensus objective criteriaavailable [5] / Adequate bone stock with appropriate implant sizing and alignment
Pneumonia / NSQIP®[1] / Recommendation of smoking cessation when applicable, use of incentive spirometer
Sepsis / Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine[3] / Positive blood cultures, SIRS criteriaduring index hospitalization
Seroma / No consensus objective criteria available / No consensus objective criteria available
Sickle cell crisis / 2014 Evidence-Based Report by Expert Panel Members[7] / Appropriate medical and pain management therapy, maintenance of hemoglobin levels above 10g/dL
Small bowel obstruction / Cope’s early diagnoses of acute abdomen [11] / Patient without flatus, abdominal pain, fever, elevated WBC
Subarachnoid hemorrhage / No consensus objective criteria available / No consensus objective criteria available
Subsidence without fracture / No consensus objective criteria available / No consensus objective criteria available
Urinary tract infection / NSQIP®[1]SCIP[14] / Catheter removed within 48 hours of surgery, perioperative antibiotics given
Vaginal bleeding / No consensus objective criteria available / No objective criteria available

DSM =Diagnostic and Statistical Manual of Mental Disorders; WBC = white blood cell; EKG = electrocardiogram; NSQIP® =National Surgical Quality Improvement Program; SCIP =Surgical Care Improvement Project; SIRS =systemic inflammatory response syndrome

References

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2.Association Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: American Psychiatric Publishing; 2013.

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4.Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P; ESC Committee for Practice Guidelines (CPG). 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation: developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012;33:2719-2747.

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8.Parvizi J, Ghanem E, Joshi A, Sharkey PF, Hozack WJ, Rothman RH. Does "excessive" anticoagulation predispose to periprosthetic infection? J Arthroplasty. 2007;22(6 suppl 2):24-28.

9.Parvizi J, Zmistowski B, Berbari EF, Bauer TW, Springer BD, Della Valle CJ, Garvin KL, Mont MA, Wongworawat MD, Zalavras CG. New definition for periprosthetic joint infection: from the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res. 2011;469:2992-2994.

10.Segura JW, Preminger GM, Assimos DG, Dretler SP, Kahn RI, Lingeman JE, Macaluso JN Jr, McCullough DL. Nephrolithiasis Clinical Guidelines Panel summary report on the management of staghorn calculi: the American Urological Association Nephrolithiasis Clinical Guidelines Panel. J Urol. 1994;151:1648-1651.

11.Silen W, Cope Z. Cope's Early Diagnosis of the Acute Abdomen. New York, NY: Oxford University Press, USA; 2005.

12.Stollman NH, Raskin JB. Diagnosis and management of diverticular disease of the colon in adults: Ad Hoc Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol. 1999;94:3110-3121.

13.Surawicz CM, Brandt LJ, Binion DG, Ananthakrishnan AN, Curry SR, Gilligan PH, McFarland LV, Mellow M, Zuckerbraun BS. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol. 2013;108:478-498; quiz 499.

14.The Joint Comission, Surgical Care Improvement Project (SCIP). Available at: Accessed March 13, 2016.