Complication rates and outcomes after outpatient shoulder arthroplasty: a systematic review

BACKGROUND: As the number of total shoulder arthroplasties (TSAs) performed annually increases, some surgeons have begun to shift toward performing TSAs in the outpatient setting. However, it is imperative to establish the safety of outpatient TSA. The purpose of this systematic review was to define...

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Autores principales: Huddleston, Hailey P., Mehta, Nabil, Polce, Evan M., Williams, Brady T., Fu, Michael C., Yanke, Adam B., Verma, Nikhil N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178605/
https://www.ncbi.nlm.nih.gov/pubmed/34136848
http://dx.doi.org/10.1016/j.jseint.2020.11.005
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author Huddleston, Hailey P.
Mehta, Nabil
Polce, Evan M.
Williams, Brady T.
Fu, Michael C.
Yanke, Adam B.
Verma, Nikhil N.
author_facet Huddleston, Hailey P.
Mehta, Nabil
Polce, Evan M.
Williams, Brady T.
Fu, Michael C.
Yanke, Adam B.
Verma, Nikhil N.
author_sort Huddleston, Hailey P.
collection PubMed
description BACKGROUND: As the number of total shoulder arthroplasties (TSAs) performed annually increases, some surgeons have begun to shift toward performing TSAs in the outpatient setting. However, it is imperative to establish the safety of outpatient TSA. The purpose of this systematic review was to define complication, readmission, and reoperation rates and patient-reported outcomes after outpatient TSA. METHODS: A systematic review of the literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using three databases (PubMed, Ovid, and Embase). English-language publications describing results on complication rates in patients who underwent TSA in an outpatient or ambulatory setting were included. All nonclinical and deidentified database studies were excluded. Bias assessment was conducted with the methodologic index for nonrandomized studies criteria. RESULTS: Seven studies describing outcomes in outpatient TSA were identified for inclusion. The included studies used varying criteria for selecting patients for an outpatient procedure. The total outpatient 90-day complication rate (commonly including hematomas, wound issues, and nerve palsies) ranged from 7.1%-11.5%. Readmission rates ranged from 0%-3.7%, and emergency and urgent care visits ranged from 2.4%-16.1%. Patient-reported outcomes improved significantly after outpatient TSA in all studies. Two studies found a higher complication rate in the comparative inpatient cohort (P = .023-.027). Methodologic index for nonrandomized studies scores ranged from 9 to 11 (of 16) for noncomparative studies (n = 3), while all comparative studies received a score of a 16 (of 24). CONCLUSION: Outpatient TSA in properly selected patients results in a similar complication rate to inpatient TSA. Further studies are needed to aid in determining proper risk stratification to direct patients to inpatient or outpatient shoulder arthroplasty.
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spelling pubmed-81786052021-06-15 Complication rates and outcomes after outpatient shoulder arthroplasty: a systematic review Huddleston, Hailey P. Mehta, Nabil Polce, Evan M. Williams, Brady T. Fu, Michael C. Yanke, Adam B. Verma, Nikhil N. JSES Int Shoulder BACKGROUND: As the number of total shoulder arthroplasties (TSAs) performed annually increases, some surgeons have begun to shift toward performing TSAs in the outpatient setting. However, it is imperative to establish the safety of outpatient TSA. The purpose of this systematic review was to define complication, readmission, and reoperation rates and patient-reported outcomes after outpatient TSA. METHODS: A systematic review of the literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using three databases (PubMed, Ovid, and Embase). English-language publications describing results on complication rates in patients who underwent TSA in an outpatient or ambulatory setting were included. All nonclinical and deidentified database studies were excluded. Bias assessment was conducted with the methodologic index for nonrandomized studies criteria. RESULTS: Seven studies describing outcomes in outpatient TSA were identified for inclusion. The included studies used varying criteria for selecting patients for an outpatient procedure. The total outpatient 90-day complication rate (commonly including hematomas, wound issues, and nerve palsies) ranged from 7.1%-11.5%. Readmission rates ranged from 0%-3.7%, and emergency and urgent care visits ranged from 2.4%-16.1%. Patient-reported outcomes improved significantly after outpatient TSA in all studies. Two studies found a higher complication rate in the comparative inpatient cohort (P = .023-.027). Methodologic index for nonrandomized studies scores ranged from 9 to 11 (of 16) for noncomparative studies (n = 3), while all comparative studies received a score of a 16 (of 24). CONCLUSION: Outpatient TSA in properly selected patients results in a similar complication rate to inpatient TSA. Further studies are needed to aid in determining proper risk stratification to direct patients to inpatient or outpatient shoulder arthroplasty. Elsevier 2021-01-16 /pmc/articles/PMC8178605/ /pubmed/34136848 http://dx.doi.org/10.1016/j.jseint.2020.11.005 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Shoulder
Huddleston, Hailey P.
Mehta, Nabil
Polce, Evan M.
Williams, Brady T.
Fu, Michael C.
Yanke, Adam B.
Verma, Nikhil N.
Complication rates and outcomes after outpatient shoulder arthroplasty: a systematic review
title Complication rates and outcomes after outpatient shoulder arthroplasty: a systematic review
title_full Complication rates and outcomes after outpatient shoulder arthroplasty: a systematic review
title_fullStr Complication rates and outcomes after outpatient shoulder arthroplasty: a systematic review
title_full_unstemmed Complication rates and outcomes after outpatient shoulder arthroplasty: a systematic review
title_short Complication rates and outcomes after outpatient shoulder arthroplasty: a systematic review
title_sort complication rates and outcomes after outpatient shoulder arthroplasty: a systematic review
topic Shoulder
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178605/
https://www.ncbi.nlm.nih.gov/pubmed/34136848
http://dx.doi.org/10.1016/j.jseint.2020.11.005
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