Assessing the Risk of Same-Day Discharge for Total Joint Arthroplasty in Patients with Preoperative Atrial Fibrillation
Authors: Justin P. Moo Young MD, Evan R. Simpson BS, Napat Intarachumnum MS, Edward Quilligan BS, Steven Barnett MD, Matthew P. Siljander MD, Nader A. Nassif MD
This study was presented as a poster at the American Academy of Orthopaedic Surgeons (AAOS) 2025 Annual Meeting and the International Society for Technology in Arthroplasty (ISTA) 2025 36th International Congress.
Background: Atrial fibrillation (AF) is a known risk factor for patients undergoing total joint arthroplasty (TJA). This study compared the incidence of emergency room (ED) visits, 30-day readmissions and 24-hour cardiac events based on patients with and without AF undergoing TJA.
Methods: All primary TJA between January 2019 and June 2023. Matched cohorts were created: patients with AF who did not undergo Same-day-discharge (SDD) (PAF) and patients without AF who underwent SDD (NAF). 761 patients remained in each cohort with mean age 73 years, 42% Women and BMI of 29.
Results: There were no significant differences in ED visit rates within 72 hours. The PAF cohort had a 5-fold increased likelihood of 30-day readmission as compared with NAF (3.42% vs 0.45%, OR 5.35, CI 2.0–14.0, p < 0.001), but there was not a significant difference in 24-hour cardiac events.
Conclusions: Patients with AF have a 5-fold increased likelihood of 30-day readmission but no difference in ED visits or 24-hour cardiac events. Appropriately selected patients with AF can safely undergo SDD following TJA.
Read more about this study here.