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Outpatient Versus Inpatient Total Shoulder Arthroplasty: A Matched Cohort Analysis of Postoperative Complications, Surgical Outcomes, and Reimbursements

INTRODUCTION: There has been a trend toward performing arthroplasty in the ambulatory setting. The primary purpose of this study was to compare outpatient and inpatient total shoulder arthroplasties (TSAs) for postoperative medical complications, healthcare utilization outcomes, and surgical outcome...

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Autores principales: Agarwal, Amil R., Wang, Kevin Y., Xu, Amy L., Ramamurti, Pradip, Zhao, Amy, Best, Matthew J., Srikumaran, Uma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656088/
https://www.ncbi.nlm.nih.gov/pubmed/37973033
http://dx.doi.org/10.5435/JAAOSGlobal-D-23-00008
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author Agarwal, Amil R.
Wang, Kevin Y.
Xu, Amy L.
Ramamurti, Pradip
Zhao, Amy
Best, Matthew J.
Srikumaran, Uma
author_facet Agarwal, Amil R.
Wang, Kevin Y.
Xu, Amy L.
Ramamurti, Pradip
Zhao, Amy
Best, Matthew J.
Srikumaran, Uma
author_sort Agarwal, Amil R.
collection PubMed
description INTRODUCTION: There has been a trend toward performing arthroplasty in the ambulatory setting. The primary purpose of this study was to compare outpatient and inpatient total shoulder arthroplasties (TSAs) for postoperative medical complications, healthcare utilization outcomes, and surgical outcomes. METHODS: Patients who underwent outpatient TSA or inpatient TSA with a minimum 5-year follow-up were identified in the PearlDiver database. These cohorts were propensity-matched based on age, sex, Charlson Comorbidity Index, smoking status, and obesity (body mass index > 30). All outcomes were analyzed using chi square and Student t-tests where appropriate. RESULTS: Outpatient TSA patients had markedly lower rates of various 90-day medical complications. Outpatient TSA patients had lower risk of aseptic loosening at 2 years postoperation and lower risk of periprosthetic joint infection at 5 years postoperation relative to inpatient TSA patients. Outpatient TSA reimbursements were markedly lower than inpatient TSA reimbursements at the 30-day, 90-day, and 1-year postoperative intervals. CONCLUSION: This study found patients undergoing outpatient TSA to be at lowers odds for both postoperative medical and surgical complications compared with those undergoing inpatient TSA. Despite increased risk of postoperative healthcare utilization for readmissions and emergency department visits, outpatient TSA was markedly less expensive at every postoperative time point assessed.
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spelling pubmed-106560882023-11-16 Outpatient Versus Inpatient Total Shoulder Arthroplasty: A Matched Cohort Analysis of Postoperative Complications, Surgical Outcomes, and Reimbursements Agarwal, Amil R. Wang, Kevin Y. Xu, Amy L. Ramamurti, Pradip Zhao, Amy Best, Matthew J. Srikumaran, Uma J Am Acad Orthop Surg Glob Res Rev Research Article INTRODUCTION: There has been a trend toward performing arthroplasty in the ambulatory setting. The primary purpose of this study was to compare outpatient and inpatient total shoulder arthroplasties (TSAs) for postoperative medical complications, healthcare utilization outcomes, and surgical outcomes. METHODS: Patients who underwent outpatient TSA or inpatient TSA with a minimum 5-year follow-up were identified in the PearlDiver database. These cohorts were propensity-matched based on age, sex, Charlson Comorbidity Index, smoking status, and obesity (body mass index > 30). All outcomes were analyzed using chi square and Student t-tests where appropriate. RESULTS: Outpatient TSA patients had markedly lower rates of various 90-day medical complications. Outpatient TSA patients had lower risk of aseptic loosening at 2 years postoperation and lower risk of periprosthetic joint infection at 5 years postoperation relative to inpatient TSA patients. Outpatient TSA reimbursements were markedly lower than inpatient TSA reimbursements at the 30-day, 90-day, and 1-year postoperative intervals. CONCLUSION: This study found patients undergoing outpatient TSA to be at lowers odds for both postoperative medical and surgical complications compared with those undergoing inpatient TSA. Despite increased risk of postoperative healthcare utilization for readmissions and emergency department visits, outpatient TSA was markedly less expensive at every postoperative time point assessed. Wolters Kluwer 2023-11-16 /pmc/articles/PMC10656088/ /pubmed/37973033 http://dx.doi.org/10.5435/JAAOSGlobal-D-23-00008 Text en Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons. https://creativecommons.org/licenses/by-nd/4.0/This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0 (CC BY-ND) which allows for redistribution, commercial and noncommercial, as long as it is passed along unchanged and in whole, with credit to the author.
spellingShingle Research Article
Agarwal, Amil R.
Wang, Kevin Y.
Xu, Amy L.
Ramamurti, Pradip
Zhao, Amy
Best, Matthew J.
Srikumaran, Uma
Outpatient Versus Inpatient Total Shoulder Arthroplasty: A Matched Cohort Analysis of Postoperative Complications, Surgical Outcomes, and Reimbursements
title Outpatient Versus Inpatient Total Shoulder Arthroplasty: A Matched Cohort Analysis of Postoperative Complications, Surgical Outcomes, and Reimbursements
title_full Outpatient Versus Inpatient Total Shoulder Arthroplasty: A Matched Cohort Analysis of Postoperative Complications, Surgical Outcomes, and Reimbursements
title_fullStr Outpatient Versus Inpatient Total Shoulder Arthroplasty: A Matched Cohort Analysis of Postoperative Complications, Surgical Outcomes, and Reimbursements
title_full_unstemmed Outpatient Versus Inpatient Total Shoulder Arthroplasty: A Matched Cohort Analysis of Postoperative Complications, Surgical Outcomes, and Reimbursements
title_short Outpatient Versus Inpatient Total Shoulder Arthroplasty: A Matched Cohort Analysis of Postoperative Complications, Surgical Outcomes, and Reimbursements
title_sort outpatient versus inpatient total shoulder arthroplasty: a matched cohort analysis of postoperative complications, surgical outcomes, and reimbursements
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656088/
https://www.ncbi.nlm.nih.gov/pubmed/37973033
http://dx.doi.org/10.5435/JAAOSGlobal-D-23-00008
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