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Risk of 30-day readmission in patients aged 75 years and older following same-day discharge for primary total shoulder arthroplasty
Authors:Puneet Gupta  Theodore Quan  Melissa A. Wright  Anand M. Murthi
Affiliation:1. Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA;2. Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA;3. Department of Orthopedic Surgery, Georgetown University School of Medicine, Washington, DC, USA
Abstract:BackgroundLittle is known about the safety and feasibility of same-day discharge following primary total shoulder arthroplasty (anatomic and reverse, SA) in geriatric patients, who may have more comorbidities and be at higher risk of surgical complications. The purpose of this study is to evaluate whether patients aged 75 years or older undergoing same-day discharge following primary SA are at an increased risk for certain complications, readmission, or mortality compared to their younger counterparts.MethodsThe 2007-2019 National Surgical Quality Improvement Program database was used to identify all primary SA patients who underwent same-day discharge. Patients were categorized into 2 cohorts, younger than 75 years and aged 75 years or older. Bivariate and multivariate analyses were performed to compare the 2 cohorts.ResultsOf 1637 SA patients who were discharged on the same day, 1246 (76.1%) patients were younger than 75 years, and 391 (23.9%) were aged 75 years or older. Bivariate analyses showed that patients aged 75 years or older were more likely to develop urinary tract infections (P = .003) and require hospital readmission (P = .002). After controlling for potential confounding variables on multivariate analysis, the cohort of patients aged 75 years or older had an increased risk of unplanned hospital readmission compared to patients younger than 75 years (odds ratio 3.99; P = .001).ConclusionPatients of age 75 years or older are at an increased risk for unplanned hospital readmission within 30 days of same-day discharge following primary SA. Surgeons and patients should be aware of this risk when evaluating SA candidates for same-day discharge.
Keywords:Total shoulder arthroplasty  Same-day discharge  Geriatrics  Complications  Shoulder  Readmission
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