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

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 shoulderarthroplasty for patients with glenohumeral osteoarthritis.Methods: The American College of Surgeons National Surgical Quality Improvement Program was used to identify۱۲,۹۸۲ patients who underwent total shoulder arthroplasty (anatomic or reverse) from ۲۰۱۱-۲۰۱۶. Demographic data,postoperative complications, and readmission within ۳۰ days were analyzed. Multivariable logistic regression was usedto determine independent risk factors for complications and for readmission occurring within ۳۰ days of surgery.Results: The mean age of the cohort was ۶۹.۱ years, ۵۶.۱% were female. Mean American Society ofAnesthesiologists (ASA) classification score was ۲.۶. The postoperative complication rate was ۵.۶% and thereadmission rate was ۲.۸% within ۳۰ days of surgery. Independent predictors for any complication includedpreoperative dependent functional status (OR ۱.۸, p <۰.۰۰۱), ASA class ۳ (OR ۳.۶, P=۰.۰۲۱) and ۴ (OR ۸.۵,p <۰.۰۰۱), age ۷۰-۷۹ (OR ۱.۴, P=۰.۰۱۹) age ≥ ۸۰ years (OR ۲.۳, p <۰.۰۰۱, and female gender (OR ۱.۶, P=۰.۰۰۱).Independent predictors for readmission included congestive heart failure (OR ۳.۴, P=۰.۰۰۲) and ASA class ۴(OR ۱۴, P = ۰.۰۱۳). Independent functional status was associated with decreased odds of readmission (OR ۰.۴,p <۰.۰۰۱).Conclusion: Patients with age greater than ۷۰ years, congestive heart failure, and ASA class ۳ and ۴ are at increasedrisk for postoperative complications and readmission. Preoperative risk stratification and medical optimization areimportant in these patients.Level of evidence: III

کلیدواژه ها:

ASA Classification ، NSQIP ، Postoperative complications ، readmission ، Total shoulder replacement