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Intravenous acetaminophen use associated with reduced odds of 30-day readmission after total knee arthroplasty
Session: EX-11
Fri, Nov. 17, 4:30-4:45 pm
Screen D

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Intravenous acetaminophen use associated with reduced odds of 30-day readmission after total knee arthroplasty


Increasing number of studies on acetaminophen (APAP) for pain control across surgical types [1-5]

Previously, intravenous (IV) formulation  was shown to be more effective than oral (PO) [5]

However, IV formulation is associated with higher costs

Cost and quality of care is important in light of new reimbursement models

However, if IV APAP is associated with lower pain levels, it may potentially decrease readmission rates due to complications


To compare total knee arthroplasty (TKA) patients who received either IV APAP or oral APAP:

30-day readmission rates

Correlated to other reports on readmissions

Extrapolated potential cost savings on a National Level


Data source, timeframe, and study cohort

•Premier™ database
•Compared TKA patients who received either IV APAP or oral APAP
•Day of surgery to postoperative day 3
•Between 2012 and 2015
•IV APAP n= 56,475,  PO APAP n= 134,216
•Literature review on 30-day readmission and prediction tools
•Extrapolation of cost savings on National Level performed
•IRB approval obtained from University of Washington by self-determination


•All cause 30-day readmissions to the same hospital recorded

Statistical analysis

•Inverse probability of treatment (propensity score) weighted regression was performed to assess the association between IV APAP and 30-day readmission
Overall Results Summary

In adjusted model, risk of 30-day readmission was 71% less likely in the IV APAP than the PO APAP cohort (OR 0.29, 95% CI 0.23 to 0.35; p<0.001)

Nationwide utilization of IV APAP in TKA may potentially result in $260 million in savings/year

Lower 30-day readmission rates in IV cohort when compared to other studies


Reduced 30-day readmission rates in TKA patients who received IV vs. PO APAP


Overall lower 30-day readmission rates when compared to literature


Potential to save $260 million if implemented nationwide


Valuable information for orthopaedic surgeons and healthcare administrators 


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2.Murata-Ooiwa M, Tsukada S, Wakui M. Intravenous Acetaminophen in Multimodal Pain Management for Patients Undergoing Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial. J Arthroplasty 2017. doi:10.1016/j.arth.2017.05.013.
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