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Updated: Dec 14, 2025
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Big Data in Total Shoulder Arthroplasty: An In-depth Comparison of National Outcomes Databases
Yining Lu1, Zain M Khazi, Bhavik H Patel
1From Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL (Mr. Lu, Mr. Patel, Dr. Agarwalla, Dr. Cancienne, and Dr. Forsythe), the Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA (Mr. Khazi), and the Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA (Dr. Werner).
Introduction:
The practice of identifying trends in surgical decision-making through large-scale patient databases is commonplace. We hypothesize that notable differences exist between claims-based and prospectively collected clinical registries.
Methods:
We queried the American College of Surgeons National Surgical Quality Improvement Program (NSQIP), a prospective surgical outcomes database, and PearlDiver (PD), a claims-based private insurance database, for patients undergoing primary total shoulder arthroplasties from 2007 to 2016. Comorbidities and 30-day complications were compared. Multiple regression analysis was performed for each cohort to identify notable contributors to 30-day revision surgery.
Results:
Significant differences were observed in demographics, comorbidities, and postoperative complications for the age-matched groups between PD and NSQIP (P < 0.05 for all). Multiple regression analysis in PD identified morbid obesity and dyspnea to lead to an increased risk for revision surgery (P = 0.001) in the <65 cohort and dyspnea and diabetes to lead to an increased risk for revision surgery in the ≥65 cohort (P = 0.015, P < 0.001). Multiple regression did not reveal any risk factors for revision surgery in the <65 age group for the NSQIP; however, congestive heart failure was found to have an increased risk for revision surgery in the ≥65 cohort (P < 0.001).
Conclusions:
Notable differences in comorbidities and complications for patients undergoing primary total shoulder arthroplasty were present between PD and NSQIP.
Level Of Evidence:
Retrospective cohort study, level III.
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