{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:50:49Z","timestamp":1777881049339,"version":"3.51.4"},"reference-count":58,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Postoperative emergency department (ED) utilization significantly reduces patient satisfaction and increases health care spending.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To identify the incidence, risk factors, and reasons for ED visits within 90 days of Achilles tendon repair (ATR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Case-control study; Level of evidence, 3<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This study utilized the PearlDiver database to identify all instances of primary ATR. Patient age, sex, Elixhauser comorbidity index (ECI), region, and insurance coverage were extracted. The incidence, timing, and primary diagnoses for those with an ED visit 90 days post-ATR were extracted. Also, the 90-day total cost was determined and compared for those with and without a postoperative ED visit. Welch\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      test and Pearson chi-square test were used to determine significant differences between groups. Multivariable logistic regressions were used to determine risk factors associated with ED utilization after ATR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 82,604 patients with an ATR identified in the database, 6939 (8.4%) had \u22651 ED visit. Of ED visits, 1506 (21.7%) occurred in the first week after ATR and 3587 (51.7%) occurred in the first 4 weeks after ATR. The mean 90-day cost for those with an ED visit was significantly greater than those without an ED visit ($7330 \u00b1 $13,383 vs $3515 \u00b1 $5787;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Independent risk factors associated with ED utilization within 90 days were younger age (odds ratio [OR], 1.02;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), female sex (OR, 1.26;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), higher ECI (OR, 1.17;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), a history of tobacco use (OR, 1.57;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and having Medicaid insurance (OR, 1.73;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Most ED visits within the first 2 weeks after ATR were for surgical-site pain (53.6%), with 62.4% of diagnoses being directly related to the surgical site. After 2 weeks following ATR, pain persisted as the most common reason for ED utilization (20.9%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>More than 8% of patients had \u22651 ED visit within 90 days of ATR, with over half occurring in the first 4 weeks. This markedly increased health care spending. Addressing regional disparities, improving Medicaid acceptance policies, and enhancing perioperative care plans, such as multimodal pain management and addressing the psychological aspects of pain, may reduce the incidence and economic burden of postoperative ED visits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671251394377","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T06:45:33Z","timestamp":1771397133000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence, Risk Factors, and Reasons for Emergency Department Utilization 90 Days After Achilles Tendon Repair"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1936-9155","authenticated-orcid":false,"given":"Alejandro M.","family":"Holle","sequence":"first","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Phoenix, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenia","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2559-6266","authenticated-orcid":false,"given":"Ammon","family":"Driggs","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Phoenix, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sailesh V.","family":"Tummala","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karan","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12584"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638280701785882"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000712"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515610505"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.01.035"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2024.03.015"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-51.12.23"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.07.012"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967114549948"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-015-0475-8"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.02.043"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0000000000000309"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00372"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.24.01210"},{"issue":"1","key":"e_1_3_3_16_2","first-page":"83","article-title":"Smokeless tobacco use is associated with a lower risk of perioperative complications and revision surgery after anatomic and reverse total shoulder arthroplasty compared to cigarette smokers","volume":"35","author":"Holle AM","year":"2025","unstructured":"Holle AM, Tummala SV, Pejic J, Lin E, Hattrup SJ, Tokish JM. 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