Journal article
Thirty-day Complications and Readmission Rates in Elderly Patients After Shoulder Arthroplasty
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, Vol.2(11), pp.e068-e068
11/01/2018
DOI: 10.5435/JAAOSGlobal-D-18-00068
PMCID: PMC6324900
PMID: 30656259
Abstract
Introduction: Shoulder arthroplasty procedures are increasingly being performed in older patients despite an increased perioperative risk. The purpose of this study is to determine the complications and 30-day readmission rates in the elderly population after shoulder arthroplasty and hemiarthroplasty.
Methods: Total shoulder arthroplasty, reverse total shoulder arthroplasty, and hemiarthroplasty cases were collected from the National Surgical Quality Improvement Program database from 2006 to 2015. The 30-day complication and readmission rates, surgical time, discharge destination, and total hospital length of stay were calculated, comparing patients by age (elderly: >= 80years; older: 65 to 79 years; younger: <65 years). Multivariable logistic regression analysis was performed to identify variables associated with any complication within 30 days of surgery.
Results:Of 11,450 patients, 1,956 (17.1%) underwent shoulder hemiarthroplasty and 9,494 (82.9%) underwent total shoulder arthroplasty. By age group, 1,708 (14.9%) were 6,073 (53.0%) were 65 to 79, and 3,669 (32.0%) were <65. The overall 30-day postoperative complication rate was significantly higher in elderly patients (15.3% versus 8.2% versus 6.8%; P < 0.001), length of stay (2.6 versus 2.1 versus 1.8 days; P < 0.001), and unplanned readmissions (5.5% versus 2.6% versus 2.3%; P < 0.001). The strongest independent variables significantly associated with any complication included revision arthroplasty indication (odds ratio [OR], 4.34; P < 0.001), fracture indication (OR, 4.14; P < 0.001), and history of cardiac disease (OR, 2.33; P < 0.001), followed by elderly age (OR, 2.01;p <0.001).
Conclusions: The 15.3% complication rate (major, 4.8%; minor, 10.7%), 2.6 days of average length of stay, and 5.5% unplanned readmission among elderly patients (>80) are significantly higher than younger patients. Although surgical indications and comorbidities are higher-quality predictors of complications, elderly patients should be appropriately counseled and medically optimized according to the perioperative risk profile before surgery.
Details
- Title: Subtitle
- Thirty-day Complications and Readmission Rates in Elderly Patients After Shoulder Arthroplasty
- Creators
- Justin Koh - Blanchfield Army Community HospitalJoseph W. Galvin - Blanchfield Army Community HospitalDavid C. Sing - Blanchfield Army Community HospitalEmily J. Curry - Boston UniversityXinning Li - Blanchfield Army Community Hospital
- Resource Type
- Journal article
- Publication Details
- Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, Vol.2(11), pp.e068-e068
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.5435/JAAOSGlobal-D-18-00068
- PMID
- 30656259
- PMCID
- PMC6324900
- ISSN
- 2474-7661
- eISSN
- 2474-7661
- Number of pages
- 6
- Language
- English
- Date published
- 11/01/2018
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984618638302771
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