Short-Term Complications and Readmission Following Total Shoulder Arthroplasty: A National Database Study

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR, USA

2 Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, MD, USA

Abstract

Background: The incidence of total shoulder arthroplasty (anatomic and reverse) is increasing as indications expand.
The purpose of this study is to identify predictors of short-term complications and readmission following total shoulder
arthroplasty for patients with glenohumeral osteoarthritis.
Methods: The American College of Surgeons National Surgical Quality Improvement Program was used to identify
12,982 patients who underwent total shoulder arthroplasty (anatomic or reverse) from 2011-2016. Demographic data,
postoperative complications, and readmission within 30 days were analyzed. Multivariable logistic regression was used
to determine independent risk factors for complications and for readmission occurring within 30 days of surgery.
Results: The mean age of the cohort was 69.1 years, 56.1% were female. Mean American Society of
Anesthesiologists (ASA) classification score was 2.6. The postoperative complication rate was 5.6% and the
readmission rate was 2.8% within 30 days of surgery. Independent predictors for any complication included
preoperative dependent functional status (OR 1.8, p <0.001), ASA class 3 (OR 3.6, P=0.021) and 4 (OR 8.5,
p <0.001), age 70-79 (OR 1.4, P=0.019) age ≥ 80 years (OR 2.3, p <0.001, and female gender (OR 1.6, P=0.001).
Independent predictors for readmission included congestive heart failure (OR 3.4, P=0.002) and ASA class 4
(OR 14, P = 0.013). Independent functional status was associated with decreased odds of readmission (OR 0.4,
p <0.001).
Conclusion: Patients with age greater than 70 years, congestive heart failure, and ASA class 3 and 4 are at increased
risk for postoperative complications and readmission. Preoperative risk stratification and medical optimization are
important in these patients.
Level of evidence: III

Keywords

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The Archives of Bone and Joint Surgery
Volume 9, Issue 3
May 2021
Pages 323-329

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History

  • Receive Date: 26 May 2020
  • Accept Date: 24 August 2020

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