Travel distance does not affect outcomes after total shoulder arthroplasty
© 2022 The Author(s).
| Veröffentlicht in: | JSES international. - 2020. - 6(2022), 6 vom: 15. Nov., Seite 903-909 |
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| 1. Verfasser: | |
| Weitere Verfasser: | , , , , , , |
| Format: | Online-Aufsatz |
| Sprache: | English |
| Veröffentlicht: |
2022
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| Zugriff auf das übergeordnete Werk: | JSES international |
| Schlagworte: | Journal Article Distance traveled Minimal clinically important difference Patient-reported outcomes Reverse total shoulder arthroplasty Total shoulder arthroplasty Value-based care |
| Zusammenfassung: | © 2022 The Author(s). Background: The purpose of this investigation was to determine the effect of travel distance on achieving the minimal clinically important difference (MCID) on all three commonly used patient-reported outcome measures (PROMs) for the shoulder more than 1 year following total shoulder arthroplasty (TSA) Methods: Patients undergoing reverse or anatomic TSA at a high-volume tertiary referral center between September 2016 and August 2018 were retrospectively reviewed. Patients were divided into 2 groups: driving distance of >50 miles from the location of surgery (referral group) and driving distance of <50 miles (local group). Scores on preoperative and postoperative PROMs, including American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE) score, and Constant Score (CS) at minimum 1-year follow-up were assessed. Chi-square analysis was used to analyze the achievement of MCID on any PROM or a combination of PROMs. Logistic regression was performed to determine whether travel distance and other variables of interest had an effect on achieving MCID on all three PROMs Results: A total of 214 patients with minimum 1-year follow-up were included in the final analysis. Of these, 165 patients (77.1%) traveled <50 miles to their orthopedic provider at the time of surgery. The local group demonstrated significantly inferior preoperative SANE scores (P < .001) and significantly higher postoperative ASES scores (P = .001). A total of 166 (77%) patients achieved all three MCIDs postoperatively. There was no significant difference between distance groups for achievement of all MCIDs (P = .328). On multivariable regression, body mass index > 30 (odds ratio [OR], 5.78; 95% confidence interval [CI], 1.53-30.28), worker's compensation status (OR, 16.78; 95% CI, 2.34-161.39), and higher preoperative ASES score (OR, 1.04; 95% CI, 1.01-1.07) were associated with an increased risk of failure to achieve all MCIDs (P < .05). Age, adjusted gross income, private insurance, and travel distance were not significantly associated with failure to achieve all MCIDs Conclusions: After controlling for age, sex, and adjusted gross income, distance traveled to a high-volume referral center did not have an effect on achieving the MCID on all three commonly used PROMs for the shoulder at least 1 year after undergoing TSA. Elevated body mass index, worker's compensation status, and higher preoperative ASES score were associated with an increased risk of failure to achieve all MCIDs after TSA |
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| Beschreibung: | Date Revised 11.11.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
| ISSN: | 2666-6383 |
| DOI: | 10.1016/j.jseint.2022.08.001 |