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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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COVID-19 as a Catalyst for Same-Day Discharge Total Shoulder Arthroplasty
Mariano E Menendez1, Noah Keegan1, Brian C Werner2
1Oregon Shoulder Institute at Southern Oregon Orthopedics, Medford, OR 97504, USA.
Journal of Clinical Medicine
|December 24, 2021
Summary
The COVID-19 pandemic accelerated same-day discharge for shoulder arthroplasty, reducing hospital stays and emergency visits. This shift occurred without negatively impacting readmission or reoperation rates for patients.
Area of Science:
- Orthopedic Surgery
- Healthcare Management
- Epidemiology
Background:
- The COVID-19 pandemic significantly disrupted healthcare systems globally.
- The impact of the pandemic on elective procedures like shoulder arthroplasty, particularly same-day discharge, was not well understood.
Purpose of the Study:
- To evaluate the effect of the COVID-19 pandemic on length of stay (LOS) and same-day discharge rates for elective total shoulder arthroplasty.
- To assess changes in resource utilization, including discharge location and 90-day outcomes (emergency department visits, readmissions, reoperations).
Main Methods:
- A retrospective study comparing 508 patients undergoing elective primary total shoulder arthroplasty.
- Two cohorts were analyzed: pre-COVID (March 2019-March 2020) and post-COVID (May 2020-March 2021).
- Key outcome measures included LOS, same-day discharge rate, discharge destination, and 90-day ED visits, readmissions, and reoperations.
Main Results:
- Post-COVID shoulder arthroplasty was associated with a significantly shorter LOS (12 vs. 16 hours) and a higher rate of same-day discharge (87.3% vs. 79.1%).
- A significant reduction in 90-day emergency department visits was observed post-COVID (7.4% vs. 13.3%).
- No significant differences were found in discharge to skilled nursing facilities, 90-day readmission rates, or 90-day reoperation rates between the cohorts.
Conclusions:
- The COVID-19 pandemic appears to have accelerated the adoption of shorter hospital stays and same-day discharge protocols for shoulder arthroplasty.
- These changes were achieved while reducing acute care utilization (ED visits) and without compromising patient safety regarding readmissions or reoperations.
