Analysis of perioperative complications in patients after total shoulder arthroplasty and reverse total shoulder arthroplasty

被引:57
作者
Jiang, Jimmy J. [1 ]
Toor, Aneet S. [1 ]
Shi, Lewis L. [1 ]
Koh, Jason L. [1 ,2 ]
机构
[1] Univ Chicago, Dept Orthopaed Surg & Rehabil Med, Chicago, IL 60637 USA
[2] NorthShore Univ HealthSyst, Dept Orthopaed Surg, Evanston, IL 60201 USA
关键词
Reverse total shoulder arthroplasty; total shoulder arthroplasty; perioperative outcome; complication; 4-YEAR FOLLOW-UP; ROTATOR CUFF; PRIMARY OSTEOARTHRITIS; SURGICAL-TREATMENT; CLINICAL-OUTCOMES; RISK-FACTORS; MULTICENTER; PNEUMONIA; COST;
D O I
10.1016/j.jse.2014.04.008
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
Background: Data directly comparing the perioperative complication rates between total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) are limited. Methods: The Nationwide Inpatient Sample database, which comprises data from a statistically representative sample of hospitals across the United States, was analyzed for the years 2010 and 2011. The International Classification of Diseases, Ninth Revision procedure codes differentiated the patients who received TSA (81.80) and RTSA (81.88). Demographic data, comorbidities, perioperative complications, and hospitalization data were compared. Results: This retrospective analysis included 19,497 patients, with 14,031 patients in the TSA group and 5466 patients in the RTSA group. Patients who underwent RTSA were older (P < .001), were more likely to be female (P < .001), and had increased rates of fracture (P < .001). The RTSA group had significantly higher perioperative rates of mortality (P = .004), pneumonia (P < .001), deep venous thrombosis (P < .001), myocardial infarction (P = .005), urinary tract infection (P < .001), and blood transfusions (P < .001). In addition, the RTSA patients had longer hospital stays (P <. 001) and higher hospital charges (P < .001). The rates of comorbidities were also higher in the patients who underwent RTSA. After adjustment for these differences in comorbidities and surgical indications with our multivariate analysis, RTSA was still independently associated with increased hospital charges (difference of $11,530; P < .001), longer hospitalization (difference of 0.24 day; P < .001), more blood transfusions (relative risk, 1.43; P < .001) and higher rates of pneumonia (relative risk, 1.61; P = .04) and deep venous thrombosis (relative risk, 2.24; P = .01). Conclusion: We found that RTSA patients, compared with TSA patients, had significantly longer length of stay, higher hospital charges that are not completely attributable to increased implant costs alone, and increased rates of perioperative complications. (C) 2014 Journal of Shoulder and Elbow Surgery Board of Trustees.
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页码:1852 / 1859
页数:8
相关论文
共 22 条
[1]  
*AG HEALTHC RES QU, COMP HCUP NHDS I S1
[2]   Intraoperative Transfusion of 1 U to 2 U Packed Red Blood Cells Is Associated with Increased 30-Day Mortality, Surgical-Site Infection, Pneumonia, and Sepsis in General Surgery Patients Discussion [J].
Richardson, J. David ;
Meredith, J. Wayne ;
Bernard, Andrew C. .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2009, 208 (05) :938-939
[3]   Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015 [J].
Day, Judd S. ;
Lau, Edmund ;
Ong, Kevin L. ;
Williams, Gerald R. ;
Ramsey, Matthew L. ;
Kurtz, Steven M. .
JOURNAL OF SHOULDER AND ELBOW SURGERY, 2010, 19 (08) :1115-1120
[4]   The influence of rotator cuff disease on the results of shoulder arthroplasty for primary osteoarthritis -: Results of a multicenter study [J].
Edwards, TB ;
Boulahia, A ;
Kempf, JF ;
Boileau, P ;
Némoz, C ;
Walch, G .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2002, 84A (12) :2240-2248
[5]   Reverse total shoulder arthroplasty for massive irreparable rotator cuff tears in patients younger than 65 years old: results after five to fifteen years [J].
Ek, Eugene T. H. ;
Neukom, Lisa ;
Catanzaro, Sabrina ;
Gerber, Christian .
JOURNAL OF SHOULDER AND ELBOW SURGERY, 2013, 22 (09) :1199-1208
[6]   Shoulder arthroplasty versus hip and knee arthroplasties - A comparison of outcomes [J].
Farmer, Kevin W. ;
Hammond, Jason W. ;
Queale, William S. ;
Keyurapan, Ekavit ;
McFarland, Edward G. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2007, (455) :183-189
[7]   Factors predicting complication rates after primary shoulder arthroplasty [J].
Farng, Eugene ;
Zingmond, David ;
Krenek, Lucie ;
SooHoo, Nelson F. .
JOURNAL OF SHOULDER AND ELBOW SURGERY, 2011, 20 (04) :557-563
[8]   Shoulder Arthroplasties have Fewer Complications than Hip or Knee Arthroplasties in US Veterans [J].
Fehringer, Edward V. ;
Mikuls, Ted R. ;
Michaud, Kaleb D. ;
Henderson, William G. ;
O'Dell, James R. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2010, 468 (03) :717-722
[9]   Hemiarthroplasty of the shoulder for rotator cuff arthropathy [J].
Field, LD ;
Dines, DM ;
Zabinski, SJ ;
Warren, RF .
JOURNAL OF SHOULDER AND ELBOW SURGERY, 1997, 6 (01) :18-23
[10]   Risk factors and clinical impact of postoperative symptomatic venous thromboembolism [J].
Gangireddy, Chethan ;
Rectenwald, John R. ;
Upchurch, Gilbert R. ;
Wakefield, Thomas W. ;
Khuri, Shukri ;
Henderson, William G. ;
Henke, Peter K. .
JOURNAL OF VASCULAR SURGERY, 2007, 45 (02) :335-341