Hospital readmissions after primary shoulder arthroplasty

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Patient Outcomes

Background:

• Shoulder arthroplasty procedures are increasingly common in the U.S.
• Limited data exists on hospital readmission rates and associated risk factors following shoulder surgery.

Purpose of the Study:

• To determine 90-day hospital readmission rates after shoulder arthroplasty.
• To identify causes and risk factors for readmission following shoulder arthroplasty.

Main Methods:

• Analysis of the State Inpatient Database (2005-2010) for 26,218 patients undergoing hemiarthroplasty, total shoulder arthroplasty (TSA), or reverse total shoulder arthroplasty (RTSA).
• Multivariate and Cox proportional hazards modeling were used to assess readmission risk factors.

Main Results:

• Overall 90-day readmission rate was 7.3%, with RTSA (11.2%) higher than hemiarthroplasty (8.2%) and TSA (6.0%).
• Medical complications (82%) were the primary cause of readmission, including osteoarthritis, DVT/PE, and pneumonia. Surgical causes included infection and dislocation.
• Increased age, Medicaid insurance, and procedures at low-volume hospitals were associated with higher readmission risk.

Conclusions:

• Reverse total shoulder arthroplasty (RTSA) is associated with higher readmission rates compared to hemiarthroplasty and TSA.
• Medical complications represent the majority of readmissions after shoulder arthroplasty, highlighting areas for improved post-operative care.