Risk factors for admission after shoulder arthroscopy.

Area of Science:

• Orthopedic Surgery
• Patient Outcomes Research

Background:

• Shoulder arthroscopy is a common outpatient orthopedic procedure.
• Unplanned hospital admissions can occur, necessitating identification of associated risk factors.
• Understanding these factors aids surgeons in patient selection and risk stratification.

Purpose of the Study:

• To determine the incidence and identify risk factors for unplanned hospital admission after shoulder arthroscopy.
• To inform surgical decision-making and improve patient management strategies.

Main Methods:

• Retrospective review of 5598 consecutive shoulder arthroscopy procedures over 10 years.
• Utilized a 2:1 control-case matching technique.
• Performed univariate and multivariate analyses to identify admission predictors.

Main Results:

• 233 patients (4.2%) required admission, most commonly for respiratory monitoring.
• Multivariate analysis identified chronic obstructive pulmonary disease (COPD), diabetes, obstructive sleep apnea (OSA), increasing age, body mass index (BMI), and operative time as risk factors.
• Regional anesthesia with monitored anesthesia care, compared to general anesthesia, decreased admission risk.

Conclusions:

• COPD, OSA, diabetes, advanced age, higher BMI, and longer operative times are significant risk factors for post-arthroscopy admission.
• Employing regional anesthesia without general anesthesia is associated with a reduced risk of hospital admission.