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Updated: Dec 21, 2025
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Predictors of mortality following shoulder arthroplasty
P Dacombe1, L Harries1, P McCann1,2
1Avon Orthopaedic Centre, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol, BS10 5NB, UK.
Insights
Shoulder arthroplasty has low mortality, but trauma cases show a 5.3 times higher risk. Malignancy and cardiac failure predict increased mortality after this surgery.
Area of Science:
- Orthopedic Surgery
- Surgical Outcomes Research
- Patient Safety
Background:
- Shoulder arthroplasty is a common procedure with varying outcomes.
- Understanding post-operative mortality is crucial for patient care and risk assessment.
Purpose of the Study:
- To determine 30-day, 90-day, and 1-year mortality rates after shoulder arthroplasty.
- To identify key predictors of mortality following the procedure.
Main Methods:
- Retrospective review of 640 shoulder arthroplasty cases (2012-2018).
- Analysis of demographic data, comorbidities, and mortality factors.
- Kaplan-Meier survival estimates and multiple regression analysis.
Main Results:
- Overall 1-year mortality was 2%.
- Trauma shoulder arthroplasty had a 5.3 hazard ratio for mortality compared to elective procedures.
- Malignancy, liver failure, cardiac failure, peptic ulcer, trauma, and revision surgery predicted increased mortality.
Conclusions:
- Shoulder arthroplasty demonstrates low short-term and 1-year mortality.
- Trauma and specific comorbidities significantly increase mortality risk.
- Identifying high-risk factors can guide preventative strategies and patient selection.
Introduction:
This study aims to determine 30-day, 90-day and 1 year mortality following shoulder arthroplasty and identify predictors of mortality.
Materials And Methods:
All shoulder arthroplasty cases performed at the host institution, between 2012 and 2018 were included. A review of patient records was completed to identify demographic data, Charlson comorbidity index, date of death and factors associated with mortality.Mortality analysis was undertaken using 1-Kaplan Meier estimates with 95% confidence intervals. Comparative analysis was performed for mortality following shoulder arthroplasty for elective vs. trauma and for primary vs. revision surgery. A multiple regression analysis was conducted to determine which factors were associated with increased mortality risk.
Results:
640 shoulder arthroplasty cases were performed in 566 patients. There were 44 deaths, 1 occurred within 90 days and 13 within 1 year. Trauma procedures had a hazard ratio of 5.3 (95% CI 1.9 to 15.0) for mortality compared to elective procedures (5 year survival trauma 78.6% (95% CI 60.7 to 89.0); elective 91.8% (95% CI 88.1 to 94.4). 1-year mortality was predicted by presence of malignancy, liver failure, cardiac failure, peptic ulcer, trauma surgery, revision surgery, intra-operative complication, transfusion and increased length of stay.
Discussion:
30-day, 90-day and 1-year mortality following shoulder arthroplasty were 0%, 0.16% and 2%; trauma procedures had a hazard ratio of 5.3 for 1-year mortality when compared to elective surgery. Malignancy, cardiac failure, liver failure, peptic ulcer and trauma surgery are associated with an increased risk of 1-year mortality.
