Analysis of the Reasons for Transferring Patients from Orthopedic Specialty Hospitals to Tertiary Hospitals After Surgery

<b>Background</b>: This study investigated the reasons for transferring patients to tertiary hospitals due to complications arising after surgery at orthopedic specialty hospitals and the treatment results. <b>Methods</b>: This retrospective cohort study was conducted on all orthopedic patients, except for the spine, at a single institution from January 2012 to May 2022. <b>Results</b>: Of 67,118 patients, 167 (0.24%) were transferred to a tertiary hospital after surgery. Patients' average age was 72.2 ± 9.2 years (range: 28-91 years), and there were 34 men and 133 women. The most common reason for transfer to a tertiary hospital was pulmonary embolism (27 patients, 16.2%), which occurred on an average 3.81 days (range: 0-23 days) after surgery, and 25 patients were transferred within 1 week after surgery. The next most common cause was acute cholecystitis (19 patients (11.4%), all of whom had undergone total knee arthroplasty), which occurred on an average 6.15 days (range: 1-14 days) after surgery. <b>Conclusions</b>: The rate of transfer from the orthopedic hospital where this study was conducted to a tertiary hospital was very low at 0.24%. Pulmonary embolism, acute cholecystitis, and cerebral infarct were the most common reasons for transfer. In particular, acute cholecystitis was the second most common reason for transfer, and caution should be taken because elderly patients may experience only atypical clinical symptoms without abdominal pain or tenderness even the day after surgery.