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Smith, Cameron, Ades, Robert, Lo, Yungtai, Stallone, Savino, Khokhar, Suhirad, Gruson, Konrad. (1403). Predictors of Return to Emergency Department and Readmission Following Primary Elective Total Shoulder Arthroplasty. , 12(7), 477-486. doi: 10.22038/abjs.2024.77508.3581
Cameron Smith; Robert Ades; Yungtai Lo; Savino Stallone; Suhirad Khokhar; Konrad I. Gruson. "Predictors of Return to Emergency Department and Readmission Following Primary Elective Total Shoulder Arthroplasty". , 12, 7, 1403, 477-486. doi: 10.22038/abjs.2024.77508.3581
Smith, Cameron, Ades, Robert, Lo, Yungtai, Stallone, Savino, Khokhar, Suhirad, Gruson, Konrad. (1403). 'Predictors of Return to Emergency Department and Readmission Following Primary Elective Total Shoulder Arthroplasty', , 12(7), pp. 477-486. doi: 10.22038/abjs.2024.77508.3581
Smith, Cameron, Ades, Robert, Lo, Yungtai, Stallone, Savino, Khokhar, Suhirad, Gruson, Konrad. Predictors of Return to Emergency Department and Readmission Following Primary Elective Total Shoulder Arthroplasty. , 1403; 12(7): 477-486. doi: 10.22038/abjs.2024.77508.3581

Predictors of Return to Emergency Department and Readmission Following Primary Elective Total Shoulder Arthroplasty

The Archives of Bone and Joint Surgery
مقاله 4، دوره 12، شماره 7، مهر 2024، صفحه 477-486    اصل مقاله (879.42 K)
نوع مقاله: RESEARCH PAPER
شناسه دیجیتال (DOI): 10.22038/abjs.2024.77508.3581
نویسندگان
Cameron Smith1؛ Robert Ades1؛ Yungtai Lo2؛ Savino Stallone3؛ Suhirad Khokhar3؛ Konrad I. Gruson* 3
1Albert Einstein College of Medicine, Bronx, New York, United States
2Albert Einstein College of Medicine - Department of Epidemiology & Population Health, Bronx, New York, United States
3Montefiore Medical Center - Department of Orthopaedic Surgery, Bronx, New York, United States
چکیده
Objectives: Returns to the Emergency Department (ED) and unplanned readmissions within 90 days of 
shoulder arthroplasty represent a significant financial burden to healthcare systems. Identifying the 
reasons and risk factors could potentially reduce their prevalence. 
Methods: A retrospective review of primary anatomic (aTSA) and reverse shoulder arthroplasty (rTSA) cases from 
January 2016 through August 2023 was performed. Demographic patient and surgical data, including age, diagnosis 
of anxiety or depression, body mass index (BMI), smoking status, age-adjusted Charlson Comorbidity Index (ACCI), 
modified 5-item fragility index (mFI-5), and hospital length of stay (LOS) was collected. Patient visits to the ED within 
12 months prior to surgery were recorded. Predictors for return to the ED within 90 days postoperatively and any 
readmissions were determined. 
Results: There were 338 cases (167 aTSA and 171 rTSA), of which 225 (67%) were women. Patients with anxiety 
(OR=2.44, 95% CI 1.11–5.33; P=0.026), surgical postoperative complications (OR=3.22, 95% CI 1.36–7.58; 
P=0.008), ED visit within 3 months prior to surgery (OR=3.80, 95% CI 1.71–8.45; P=0.001), ED visit 3 to 6 months 
prior to surgery (OR=2.60, 95% CI 1.12–6.05; P=0.027), and ED visit 6 to 12 months prior to surgery (OR=2.12, 
95% CI 1.02–4.41; P=0.045) were more likely to have ED visit within 90 days postoperatively. Patients with prior 
ipsilateral shoulder surgery (OR=3.32, 95% CI 1.21–9.09; P=0.02), surgical postoperative complications (OR=13.92, 
95% CI 5.04–38.42; P<0.001), an ED visit within 3 to 6 months preoperatively (OR=8.47, 95% CI 2.84–25.27; 
P<0.001), and an mFI-5 ≥2 (OR=3.66, 95% CI 1.35–9.91; P=0.011) were more likely to be readmitted within 90 
days. 
Conclusion: Patients who present to the ED within 12 months prior to shoulder arthroplasty, those with anxiety, 
those with surgical complications and those with higher fragility should be monitored closely during the early 
postoperative period to minimize returns to the ED and/or unplanned readmissions. 
 Level of evidence: III
کلیدواژه‌ها
90-day readmission؛ Modified fragility index؛ Return to emergency department؛ Risk factors
مراجع
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