Total shoulder arthroplasty: Risk factors for a prolonged length of stay. A retrospective cohort study

Matthew J. Hartwell*, Patrick Nelson, Daniel J. Johnson, Richard W. Nicolay, Robert A. Christian, Ryan S. Selley, Michael A. Terry, Vehniah K. Tjong

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)534-538
Number of pages5
JournalCurrent Orthopaedic Practice
Issue number6
StatePublished - Nov 1 2019


  • length of stay
  • risk factors
  • total shoulder arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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