Increased Shoulder Arthroscopy Time Is Associated With Overnight Hospital Stay and Surgical Site Infection

被引:54
作者
Boddapati, Venkat [1 ]
Fu, Michael C. [1 ]
Schairer, William W. [1 ]
Ranawat, Anil S. [1 ]
Dines, David M. [1 ]
Taylor, Samuel A. [1 ]
Dines, Joshua S. [1 ]
机构
[1] Hosp Special Surg, Dept Orthoped Surg, 535 East 70th St, New York, NY 10021 USA
关键词
AMBULATORY SURGERY CENTERS; ROTATOR CUFF REPAIR; OPEN BANKART REPAIR; RISK-FACTORS; PROPIONIBACTERIUM-ACNES; PHYSICIAN OWNERSHIP; COMPLICATIONS; METAANALYSIS; RELIABILITY; DURATION;
D O I
10.1016/j.arthro.2017.08.243
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: The purpose of this study was to characterize the rates of short-term postoperative complications, readmissions, and overnight hospital stays as a function of shoulder arthroscopy procedure time. A secondary aim of this current study was to identify baseline patient risk factors for adverse outcomes. Methods: This study used the American College of Surgeons National Surgical Quality Improvement Program registry from 2012 to 2015. Shoulder arthroscopy cases were categorized based on operative time, either <45 minutes, between 45 and 90 minutes, or >90 minutes. The rates of 30-day postoperative complications, readmissions, and overnight hospital stays were compared with bivariate and multivariate analysis. Results: In total, 33,095 shoulder arthroscopy procedures were identified. Of these, 7,027 (21.2%) were <45 minutes, 16,610 (50.2%) were between 45 and 90 minutes, and 9,458 (28.6%) were >90 minutes. Multivariate analysis identified increased the risk of superficial surgical site infections (SSIs) for procedures lasting between 45 and 90 minutes (odds ratio [OR] = 3.63; P = .036) and for procedures >90 minutes (OR = 4.40; P = .019), compared with procedures <45 minutes. Furthermore, there was an increased risk of overnight hospital stay for patients who had a shoulder arthroscopy lasting between 45 and 90 minutes (OR = 1.33) and > 90 minutes (OR = 2.14), compared with procedures <45 minutes. A body mass index > 30 kg/m(2) was an independent predictor of both overnight hospital stay and superficial SSI (P = .020). Age > 60, female gender, American Society of Anesthesiologists class >= 3, and a history of diabetes mellitus, hypertension, or chronic obstructive pulmonary disease were additional predictors of overnight hospital stay (P < .001 for all comparisons, unless otherwise noted). Conclusions: Increased shoulder arthroscopy procedure time is associated with adverse short-term outcomes, particularly superficial SSI and overnight hospital stay. This information may be useful for patient counseling and postoperative risk stratification, as operative time is an easily measured surrogate for surgical complexity or difficulty.
引用
收藏
页码:363 / 368
页数:6
相关论文
共 33 条
[1]  
[Anonymous], BMI CLASSIFICATION
[2]   Arthroscopic versus open acromiloplasty - A systematic review [J].
Barfield, L. Cole ;
Kuhn, John E. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2007, (455) :64-71
[3]   Open versus arthroscopic rotator cuff repair: A comparative view of 96 cases [J].
Buess, E ;
Steuber, KU ;
Waibl, B .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2005, 21 (05) :597-604
[4]   Intraoperative Corticosteroid Injection at the Time of Knee Arthroscopy Is Associated With Increased Postoperative Infection Rates in a Large Medicare Population [J].
Cancienne, Jourdan M. ;
Gwathmey, Winston ;
Werner, Brian C. .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2016, 32 (01) :90-95
[5]   Effectiveness and safety of arthroscopic versus open Bankart repair for recurrent anterior shoulder dislocation: a meta-analysis of clinical trial data [J].
Chen, Long ;
Xu, Zhao ;
Peng, Jing ;
Xing, Fei ;
Wang, Hong ;
Xiang, Zhou .
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 2015, 135 (04) :529-538
[6]   The effect of normal saline irrigation at different temperatures on the surface of articular cartilage: An experimental study in the rat [J].
Cheng, SC ;
Jou, IM ;
Chern, TC ;
Wang, PH ;
Chen, WC .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2004, 20 (01) :55-61
[7]   Does the duration of surgery affect outcomes in patients undergoing coronary artery bypass grafting? [J].
Chu, Danny ;
Bakaeen, Faisal G. ;
Wang, Xing Li ;
LeMaire, Scott A. ;
Coselli, Joseph S. ;
Huh, Joseph .
AMERICAN JOURNAL OF SURGERY, 2008, 196 (05) :652-656
[8]   The Incidence of Propionibacterium acnes in Shoulder Arthroscopy [J].
Chuang, Michael J. ;
Jancosko, Jason J. ;
Mendoza, Vivian ;
Nottage, Wesley M. .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2015, 31 (09) :1702-1707
[9]   Arthroscopic versus open bankart repair for traumatic anterior shoulder instability [J].
Cole, BJ ;
Warner, JJP .
CLINICS IN SPORTS MEDICINE, 2000, 19 (01) :19-+
[10]  
Colvin AC, 2012, J BONE JOINT SURG AM, V94A, P227, DOI [10.2106/JBJS.J.01886, 10.2106/JBJS.J.00739]