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Relative Complications and Trends of Outpatient Total Shoulder Arthroplasty.
Orthopedics. 2018 May 01; 41(3):e400-e409.O

Abstract

Outpatient arthroplasty is an appealing option among select patient populations as a mechanism for reducing health care expenditure. The purpose of this study was to determine the nationwide trends and complication profile of outpatient total shoulder arthroplasty (TSA). The authors reviewed a national administrative claims database to identify patients undergoing TSA as outpatients and inpatients from 2007 to 2016. The incidence of perioperative surgical and medical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes. Multivariate logistic regression adjusted for age, sex, and Charlson Comorbidity Index was used to calculate odds ratios of complications among outpatients relative to inpatients undergoing TSA. The query identified 1555 patients who underwent outpatient TSA and 15,987 patients who underwent inpatient TSA. The median age was in the 70 to 74 years age group in both the outpatient and the inpatient cohorts, and the age distribution was comparable between the 2 cohorts (P=.287). The incidence of both outpatient (P<.001) and inpatient (P<.001) TSA increased during the study period. On adjustment for age, sex, and comorbidities, patients undergoing outpatient TSA had significantly lower rates of stiffness requiring manipulation under anesthesia (outpatient, 1.09%; inpatient, 2.35%; odds ratio, 0.52; 95% confidence interval, 0.38-0.71; P<.001) and higher rates of postoperative surgical site infections requiring reoperation (outpatient, 0.90%; inpatient, 0.65%; odds ratio, 1.65; 95% confidence interval, 1.15-2.35; P<.001) at 1 year. Rates of all other postoperative complications were comparable. Ambulatory TSA is increasing in incidence nationwide and is associated with an overall favorable postoperative complication profile. [Orthopedics. 2018; 41(3):e400-e409.].

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

29658980

Citation

Arshi, Armin, et al. "Relative Complications and Trends of Outpatient Total Shoulder Arthroplasty." Orthopedics, vol. 41, no. 3, 2018, pp. e400-e409.
Arshi A, Leong NL, Wang C, et al. Relative Complications and Trends of Outpatient Total Shoulder Arthroplasty. Orthopedics. 2018;41(3):e400-e409.
Arshi, A., Leong, N. L., Wang, C., Buser, Z., Wang, J. C., Vezeridis, P. S., McAllister, D. R., & Petrigliano, F. A. (2018). Relative Complications and Trends of Outpatient Total Shoulder Arthroplasty. Orthopedics, 41(3), e400-e409. https://doi.org/10.3928/01477447-20180409-01
Arshi A, et al. Relative Complications and Trends of Outpatient Total Shoulder Arthroplasty. Orthopedics. 2018 May 1;41(3):e400-e409. PubMed PMID: 29658980.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relative Complications and Trends of Outpatient Total Shoulder Arthroplasty. AU - Arshi,Armin, AU - Leong,Natalie L, AU - Wang,Christopher, AU - Buser,Zorica, AU - Wang,Jeffrey C, AU - Vezeridis,Peter S, AU - McAllister,David R, AU - Petrigliano,Frank A, Y1 - 2018/04/16/ PY - 2017/09/30/received PY - 2018/01/22/accepted PY - 2018/4/17/pubmed PY - 2018/9/18/medline PY - 2018/4/17/entrez SP - e400 EP - e409 JF - Orthopedics JO - Orthopedics VL - 41 IS - 3 N2 - Outpatient arthroplasty is an appealing option among select patient populations as a mechanism for reducing health care expenditure. The purpose of this study was to determine the nationwide trends and complication profile of outpatient total shoulder arthroplasty (TSA). The authors reviewed a national administrative claims database to identify patients undergoing TSA as outpatients and inpatients from 2007 to 2016. The incidence of perioperative surgical and medical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes. Multivariate logistic regression adjusted for age, sex, and Charlson Comorbidity Index was used to calculate odds ratios of complications among outpatients relative to inpatients undergoing TSA. The query identified 1555 patients who underwent outpatient TSA and 15,987 patients who underwent inpatient TSA. The median age was in the 70 to 74 years age group in both the outpatient and the inpatient cohorts, and the age distribution was comparable between the 2 cohorts (P=.287). The incidence of both outpatient (P<.001) and inpatient (P<.001) TSA increased during the study period. On adjustment for age, sex, and comorbidities, patients undergoing outpatient TSA had significantly lower rates of stiffness requiring manipulation under anesthesia (outpatient, 1.09%; inpatient, 2.35%; odds ratio, 0.52; 95% confidence interval, 0.38-0.71; P<.001) and higher rates of postoperative surgical site infections requiring reoperation (outpatient, 0.90%; inpatient, 0.65%; odds ratio, 1.65; 95% confidence interval, 1.15-2.35; P<.001) at 1 year. Rates of all other postoperative complications were comparable. Ambulatory TSA is increasing in incidence nationwide and is associated with an overall favorable postoperative complication profile. [Orthopedics. 2018; 41(3):e400-e409.]. SN - 1938-2367 UR - https://www.unboundmedicine.com/medline/citation/29658980/Relative_Complications_and_Trends_of_Outpatient_Total_Shoulder_Arthroplasty_ L2 - https://www.healio.com/doiresolver?doi=10.3928/01477447-20180409-01 DB - PRIME DP - Unbound Medicine ER -