Septuagenarians versus octogenarians in elective upper extremity procedures.

Area of Science:

• Orthopedic surgery
• Geriatric medicine
• Health services research

Background:

• Elective shoulder procedures are rising in older adults due to population aging.
• Existing research often focuses on total shoulder arthroplasty, with limited data on other procedures.
• Outcomes across different age groups within older adults are not well-defined.

Purpose of the Study:

• To compare postoperative outcomes between septuagenarians and octogenarians undergoing elective shoulder surgery.
• To identify specific risks associated with advanced age in this surgical population.
• To inform perioperative care strategies for elderly patients.

Main Methods:

• Utilized the American College of Surgeons National Surgical Quality Improvement Program database (2011-2022).
• Included patients aged 70-89 years undergoing elective shoulder procedures.
• Stratified patients into septuagenarians (70-79) and octogenarians (80-89) and used multivariable logistic regression for analysis.

Main Results:

• Octogenarians (80-89 years) showed significantly higher odds of unplanned readmission (OR 1.57) and non-home discharge (OR 2.44) compared to septuagenarians (70-79 years).
• No significant differences were found in overall complications, reoperation rates, or 30-day mortality between the groups.
• The study included 12,099 patients: 10,810 septuagenarians and 1289 octogenarians.

Conclusions:

• Octogenarians face increased risks of readmission and non-home discharge after elective shoulder surgery.
• Short-term complication rates were similar between septuagenarians and octogenarians.
• Enhanced perioperative planning and discharge optimization are crucial for octogenarian patients undergoing elective shoulder procedures.