Identifying risk factors for 30-day readmission after outpatient total shoulder arthroplasty to aid in patient selection

© 2023 The Author(s).

Bibliographische Detailangaben
Veröffentlicht in:JSES international. - 2020. - 7(2023), 6 vom: 26. Nov., Seite 2425-2432
1. Verfasser: Ling, Kenny (VerfasserIn)
Weitere Verfasser: Tsouris, Nicholas, Nazemi, Alireza, Komatsu, David E, Wang, Edward D
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2023
Zugriff auf das übergeordnete Werk:JSES international
Schlagworte:Journal Article Outpatient Patient selection Postoperative complications Readmission Reverse shoulder arthroplasty Same-day discharge Total shoulder arthroplasty
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520 |a Background: A recent meta-analysis comparing inpatient and outpatient total shoulder arthroplasty (TSA) showed no statistically significant differences in complications, readmissions, revisions, and infections. However, there remains no research on the appropriate patient selection for outpatient TSA surgeries. This retrospective review seeks to aid surgeons in refining a safe patient selection algorithm by evaluating risk factors through a large database analysis of TSA surgeries 
520 |a Methods: Patients who underwent TSA between 2015 and 2020 were identified in the National Surgical Quality Improvement Program database. Patients with a hospital stay of 0 days were designated as outpatient procedures. Multivariate analyses were used to determine risk factors for 30-day readmission following outpatient TSA and whether risk factors remained significant following overnight hospital stay 
520 |a Results: A total of 2431 outpatient TSA patients were identified. The incidence of 30-day readmission was 1.8%. The majority of readmissions were due to pulmonary complications. The clinically significant risk factors for 30-day readmission were chronic steroid use (odds ratio [OR] 3.55, 95% confidence interval [CI] 1.34-9.43; P = .011), chronic obstructive pulmonary disease (COPD) (OR 3.11, 95% CI 1.16-8.34; P = .024), and current smoking status (OR 2.27, 95% CI 1.02-5.03; P = .045). After overnight hospital stay, chronic steroid use and current smoking status were not significant, but COPD remained significant 
520 |a Conclusion: Patients with chronic steroid use, COPD, or current smoking status are at increased risk for 30-day readmission. Inpatient hospital stay appears to benefit patients with chronic steroid use and current smoking status. Patients with COPD should be admitted for inpatient stay postoperatively but may still have high 30-day readmission rates following discharge 
650 4 |a Journal Article 
650 4 |a Outpatient 
650 4 |a Patient selection 
650 4 |a Postoperative complications 
650 4 |a Readmission 
650 4 |a Reverse shoulder arthroplasty 
650 4 |a Same-day discharge 
650 4 |a Total shoulder arthroplasty 
700 1 |a Tsouris, Nicholas  |e verfasserin  |4 aut 
700 1 |a Nazemi, Alireza  |e verfasserin  |4 aut 
700 1 |a Komatsu, David E  |e verfasserin  |4 aut 
700 1 |a Wang, Edward D  |e verfasserin  |4 aut 
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