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Comparison of outpatient vs. inpatient anatomic total shoulder arthroplasty: a propensity score–matched analysis of 20,035 procedures

BACKGROUND: As the proportion of anatomic total shoulder arthroplasty (aTSA) operations performed at outpatient surgical sites continues to increase, it is important to evaluate the clinical implications of this evolution in care. METHODS: Patients who underwent TSA for glenohumeral osteoarthritis f...

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Autores principales: Kucharik, Michael P., Varady, Nathan H., Best, Matthew J., Rudisill, Samuel S., Naessig, Sara A., Eberlin, Christopher T., Martin, Scott D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8811397/
https://www.ncbi.nlm.nih.gov/pubmed/35141670
http://dx.doi.org/10.1016/j.jseint.2021.09.015
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author Kucharik, Michael P.
Varady, Nathan H.
Best, Matthew J.
Rudisill, Samuel S.
Naessig, Sara A.
Eberlin, Christopher T.
Martin, Scott D.
author_facet Kucharik, Michael P.
Varady, Nathan H.
Best, Matthew J.
Rudisill, Samuel S.
Naessig, Sara A.
Eberlin, Christopher T.
Martin, Scott D.
author_sort Kucharik, Michael P.
collection PubMed
description BACKGROUND: As the proportion of anatomic total shoulder arthroplasty (aTSA) operations performed at outpatient surgical sites continues to increase, it is important to evaluate the clinical implications of this evolution in care. METHODS: Patients who underwent TSA for glenohumeral osteoarthritis from 2007 to 2019 were identified in the American College of Surgeons National Surgical Quality Improvement Program registry. Demographic data and 30-day outcomes were collected, and patients were separated into inpatient and outpatient (defined as same day discharge) groups. To control for confounding variables, a propensity score–matching algorithm was utilized. Outcomes included 30-day adverse events, readmission, and operative time. RESULTS: A total of 20,035 patients who underwent aTSA between 2007 and 2019 were identified: 18,707 inpatient aTSAs and 1328 outpatient aTSAs. On matching, there were no significant differences in patient characteristics between inpatient and outpatient cohorts. Patients who underwent outpatient aTSA were less likely to experience a serious adverse event when compared with their matched inpatient aTSA counterparts (outpatient: 1.1% vs. inpatient: 2.1%, P = .03). Outpatient aTSA was associated with similar rates of all specific individual complications and readmissions (1.5% vs. 1.9%, P = .31). CONCLUSION: When compared with a propensity score–matched cohort of inpatient counterparts, the present study found outpatient aTSA was associated with significantly reduced severe adverse events and similar readmission rates. These findings support the growing use of outpatient aTSA in appropriately selected patients.
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spelling pubmed-88113972022-02-08 Comparison of outpatient vs. inpatient anatomic total shoulder arthroplasty: a propensity score–matched analysis of 20,035 procedures Kucharik, Michael P. Varady, Nathan H. Best, Matthew J. Rudisill, Samuel S. Naessig, Sara A. Eberlin, Christopher T. Martin, Scott D. JSES Int Shoulder BACKGROUND: As the proportion of anatomic total shoulder arthroplasty (aTSA) operations performed at outpatient surgical sites continues to increase, it is important to evaluate the clinical implications of this evolution in care. METHODS: Patients who underwent TSA for glenohumeral osteoarthritis from 2007 to 2019 were identified in the American College of Surgeons National Surgical Quality Improvement Program registry. Demographic data and 30-day outcomes were collected, and patients were separated into inpatient and outpatient (defined as same day discharge) groups. To control for confounding variables, a propensity score–matching algorithm was utilized. Outcomes included 30-day adverse events, readmission, and operative time. RESULTS: A total of 20,035 patients who underwent aTSA between 2007 and 2019 were identified: 18,707 inpatient aTSAs and 1328 outpatient aTSAs. On matching, there were no significant differences in patient characteristics between inpatient and outpatient cohorts. Patients who underwent outpatient aTSA were less likely to experience a serious adverse event when compared with their matched inpatient aTSA counterparts (outpatient: 1.1% vs. inpatient: 2.1%, P = .03). Outpatient aTSA was associated with similar rates of all specific individual complications and readmissions (1.5% vs. 1.9%, P = .31). CONCLUSION: When compared with a propensity score–matched cohort of inpatient counterparts, the present study found outpatient aTSA was associated with significantly reduced severe adverse events and similar readmission rates. These findings support the growing use of outpatient aTSA in appropriately selected patients. Elsevier 2021-11-15 /pmc/articles/PMC8811397/ /pubmed/35141670 http://dx.doi.org/10.1016/j.jseint.2021.09.015 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
Kucharik, Michael P.
Varady, Nathan H.
Best, Matthew J.
Rudisill, Samuel S.
Naessig, Sara A.
Eberlin, Christopher T.
Martin, Scott D.
Comparison of outpatient vs. inpatient anatomic total shoulder arthroplasty: a propensity score–matched analysis of 20,035 procedures
title Comparison of outpatient vs. inpatient anatomic total shoulder arthroplasty: a propensity score–matched analysis of 20,035 procedures
title_full Comparison of outpatient vs. inpatient anatomic total shoulder arthroplasty: a propensity score–matched analysis of 20,035 procedures
title_fullStr Comparison of outpatient vs. inpatient anatomic total shoulder arthroplasty: a propensity score–matched analysis of 20,035 procedures
title_full_unstemmed Comparison of outpatient vs. inpatient anatomic total shoulder arthroplasty: a propensity score–matched analysis of 20,035 procedures
title_short Comparison of outpatient vs. inpatient anatomic total shoulder arthroplasty: a propensity score–matched analysis of 20,035 procedures
title_sort comparison of outpatient vs. inpatient anatomic total shoulder arthroplasty: a propensity score–matched analysis of 20,035 procedures
topic Shoulder
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8811397/
https://www.ncbi.nlm.nih.gov/pubmed/35141670
http://dx.doi.org/10.1016/j.jseint.2021.09.015
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