TY - JOUR
T1 - Total shoulder arthroplasty
T2 - Risk factors for a prolonged length of stay. A retrospective cohort study
AU - Hartwell, Matthew J.
AU - Nelson, Patrick
AU - Johnson, Daniel J.
AU - Nicolay, Richard W.
AU - Christian, Robert A.
AU - Selley, Ryan S.
AU - Terry, Michael A.
AU - Tjong, Vehniah K.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Background:Recent studies describe safe outcomes for outpatient total shoulder arthroplasty. This study identifies risk factors for hospital admissions exceeding 24 hr.Methods:The National Surgical Quality Improvement Program database was queried for billing codes related to total shoulder arthroplasty. Patients were grouped according to length of stay, ≤24 hr or >24 hr. Univariate and multivariate analyses were used to identify patient demographics, preoperative comorbidities, and intraoperative risk factors for prolonged hospitalizations.Results:Of the 14,339 patients who met the inclusion criteria, 6,507 patients (45.3%) had a length of stay ≤24 hr. Multivariate analysis identified age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.03), American Society of Anesthesiology classification (OR, 1.5; 95% CI, 1.4-1.6), diabetes (OR, 1.7; 95% CI, 1.4-2.0), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.2-1.6), congestive heart failure (OR, 2.7; 95% CI, 1.3-5.3), dialysis (OR, 2.5; 95% CI, 1.3, 4.8), history of a bleeding disorder (OR, 1.5; 95% CI, 1.2-1.9), and operative time (OR, 1.01; 95% CI, 1.01-1.01) as risk factors for prolonged hospitalization. Male gender was a protective factor for prolonged hospitalization (OR, 0.50; 95% CI, 0.46-0.53).Conclusions:Female gender, increasing age, American Society of Anesthesiology classification, operative time, or a history of diabetes, chronic obstructive pulmonary disease, congestive heart failure, or a bleeding disorder are risk factors for prolonged hospitalization following total shoulder arthroplasty.Level of Evidence:Level III.
AB - Background:Recent studies describe safe outcomes for outpatient total shoulder arthroplasty. This study identifies risk factors for hospital admissions exceeding 24 hr.Methods:The National Surgical Quality Improvement Program database was queried for billing codes related to total shoulder arthroplasty. Patients were grouped according to length of stay, ≤24 hr or >24 hr. Univariate and multivariate analyses were used to identify patient demographics, preoperative comorbidities, and intraoperative risk factors for prolonged hospitalizations.Results:Of the 14,339 patients who met the inclusion criteria, 6,507 patients (45.3%) had a length of stay ≤24 hr. Multivariate analysis identified age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.03), American Society of Anesthesiology classification (OR, 1.5; 95% CI, 1.4-1.6), diabetes (OR, 1.7; 95% CI, 1.4-2.0), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.2-1.6), congestive heart failure (OR, 2.7; 95% CI, 1.3-5.3), dialysis (OR, 2.5; 95% CI, 1.3, 4.8), history of a bleeding disorder (OR, 1.5; 95% CI, 1.2-1.9), and operative time (OR, 1.01; 95% CI, 1.01-1.01) as risk factors for prolonged hospitalization. Male gender was a protective factor for prolonged hospitalization (OR, 0.50; 95% CI, 0.46-0.53).Conclusions:Female gender, increasing age, American Society of Anesthesiology classification, operative time, or a history of diabetes, chronic obstructive pulmonary disease, congestive heart failure, or a bleeding disorder are risk factors for prolonged hospitalization following total shoulder arthroplasty.Level of Evidence:Level III.
KW - length of stay
KW - risk factors
KW - total shoulder arthroplasty
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U2 - 10.1097/BCO.0000000000000801
DO - 10.1097/BCO.0000000000000801
M3 - Article
AN - SCOPUS:85072338550
SN - 1940-7041
VL - 30
SP - 534
EP - 538
JO - Current Orthopaedic Practice
JF - Current Orthopaedic Practice
IS - 6
ER -
