Differences in 30-day outcomes between inpatient and outpatient total elbow arthroplasty (TEA)

Andrew A. Furman*, Alain E. Sherman, Mark A. Plantz, Guido Marra, Matthew D. Saltzman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: As the health care system in the United States shifts toward value-based care, there has been increased interest in performing total joint arthroplasty in the outpatient setting to optimize costs, outcomes, and patient satisfaction. Several studies have demonstrated success in performing ambulatory total knee and hip arthroplasty. The purpose of this study was to compare short-term outcomes and complications after total elbow arthroplasty (TEA) across the inpatient and outpatient operative settings. Methods: The American College of Surgeons National Quality Improvement Program database was queried to identify 575 patients undergoing primary TEA using the Current Procedural Terminology code 24363. Of this sample, 458 were inpatient and 117 were outpatient procedures. Propensity score matching using a 3:1 inpatient-to-outpatient ratio was performed to account for baseline differences in several variables—age, sex, body mass index class, American Society of Anesthesiologists class, and various comorbidities—between the inpatient and outpatient groups. After matching, the rates of various short-term outcomes and complications were compared between the inpatient and outpatient groups. Results: Inpatient TEA was associated with a higher rate of complications relative to outpatient TEA, including non-home discharge (14.9% vs. 7.5%, P = .05), unplanned hospital readmission (7.4% vs. 0.9%, P = .01), surgical complications (7.6% vs. 2.6%, P = .04), and medical complications (3.6% vs. 0.0%, P = .04). Conclusion: Outpatient TEA has a lower short-term complication rate than inpatient TEA. Outpatient TEA should be considered for patients for whom such a discharge pathway is feasible. Future research should focus on risk stratification of patients and specific criteria for deciding when to pursue outpatient TEA.

Original languageEnglish (US)
Pages (from-to)2640-2645
Number of pages6
JournalJournal of Shoulder and Elbow Surgery
Volume29
Issue number12
DOIs
StatePublished - Dec 2020

Keywords

  • Level III
  • Retrospective Cohort Comparison using Large Database
  • Total elbow arthroplasty
  • Treatment Study
  • ambulatory
  • complications
  • inpatient
  • outcomes
  • outpatient

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Fingerprint

Dive into the research topics of 'Differences in 30-day outcomes between inpatient and outpatient total elbow arthroplasty (TEA)'. Together they form a unique fingerprint.

Cite this