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Published in: International Orthopaedics 1/2018

01-01-2018 | Original Paper

The influence of gender on early adverse events, hospital charges and length of stay after shoulder arthroplasty

Authors: Bryan M. Saltzman, Bryce Basques, Timothy Leroux, Rachel M. Frank, Gregory P. Nicholson, Nikhil N. Verma, Anthony A. Romeo

Published in: International Orthopaedics | Issue 1/2018

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Abstract

Purpose

To identify differences in demographics, diagnosis, arthroplasty type, early adverse events, length of stay, and hospital costs between men and women undergoing shoulder arthroplasty.

Methods

We used a nationally representative U.S. population database to determine annual rates of shoulder arthroplasty (SA) in patients (2002–2011). Early adverse events, length-of-stay and hospitalization costs were determined, and compared between patient genders.

Results

A cohort of 372,753 patients underwent total-SA (TSA) (59.7% females). Females were significantly older, more often had Medicare insurance, had a higher proportion of fracture diagnosis, more often underwent hemiarthroplasty (HA), and had significantly lower odds of any adverse event, MI, and sepsis, but higher odds of peripheral nerve injury. Females had significantly greater hospital lengths of stay for all combined procedures, and isolated TSA, reverse-TSA, and HA. Hospital costs were significantly lower in females for all combined procedures and HA.

Conclusions

Male patients had significantly higher odds of adverse events, death, MI, and sepsis following SA. Female patients had significantly longer lengths of stay but lower hospital charges following SA.
Literature
1.
go back to reference Day JS, Lau E, Ong KL, Williams GR, Ramsey ML, Kurtz SM (2010) Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015. J Shoulder Elb Surg 19:1115–1120CrossRef Day JS, Lau E, Ong KL, Williams GR, Ramsey ML, Kurtz SM (2010) Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015. J Shoulder Elb Surg 19:1115–1120CrossRef
2.
go back to reference Khatib O, Onyekwelu I, Yu S, Zuckerman JD (2010) Shoulder arthroplasty in New York State, 1991 to 2010: changing patterns of utilization. J Shoulder Elbow Surg 24(10):e286–e291CrossRef Khatib O, Onyekwelu I, Yu S, Zuckerman JD (2010) Shoulder arthroplasty in New York State, 1991 to 2010: changing patterns of utilization. J Shoulder Elbow Surg 24(10):e286–e291CrossRef
3.
go back to reference Kim SH, Wise BL, Zhang Y, Szabo RM (2011) Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am 93:2249–2254CrossRefPubMed Kim SH, Wise BL, Zhang Y, Szabo RM (2011) Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am 93:2249–2254CrossRefPubMed
4.
go back to reference Westermann RW, Pugely AJ, Martin CT, Gao Y, Wolf BR, Hettrich CM (2015) Reverse shoulder arthroplasty in the United States: a comparison of national volume, patient demographics, complications, and surgical indications. Iowa Orthop J 35:1–7PubMedPubMedCentral Westermann RW, Pugely AJ, Martin CT, Gao Y, Wolf BR, Hettrich CM (2015) Reverse shoulder arthroplasty in the United States: a comparison of national volume, patient demographics, complications, and surgical indications. Iowa Orthop J 35:1–7PubMedPubMedCentral
5.
go back to reference Schairer WW, Nwachukwu BU, Lyman S, Craig EV, Gulotta LV (2015) National utilization of reverse total shoulder arthroplasty in the United States. J Shoulder Elb Surg 24(1):91–97CrossRef Schairer WW, Nwachukwu BU, Lyman S, Craig EV, Gulotta LV (2015) National utilization of reverse total shoulder arthroplasty in the United States. J Shoulder Elb Surg 24(1):91–97CrossRef
6.
go back to reference Griffin JW, Novicoff WM, Browne JA, Brockmeier SF (2014) Morbid obesity in total shoulder arthroplasty: risk, outcomes, and cost analysis. J Shoulder Elb Surg 23:1444–1448CrossRef Griffin JW, Novicoff WM, Browne JA, Brockmeier SF (2014) Morbid obesity in total shoulder arthroplasty: risk, outcomes, and cost analysis. J Shoulder Elb Surg 23:1444–1448CrossRef
7.
go back to reference Johnson CC, Sodha S, Garzon-Muvdi J, Petersen SA, McFarland EG (2014) Does preoperative American Society of Anesthesiologists score relate to complications after total shoulder arthroplasty. Clin Orthop Relat Res 472:1589–1596CrossRefPubMed Johnson CC, Sodha S, Garzon-Muvdi J, Petersen SA, McFarland EG (2014) Does preoperative American Society of Anesthesiologists score relate to complications after total shoulder arthroplasty. Clin Orthop Relat Res 472:1589–1596CrossRefPubMed
8.
go back to reference Waterman BR, Dunn JC, Bader J, Urrea L, Schoenfeld AJ, Belmont PJ Jr (2015) Thirty-day morbidity and mortality after elective total shoulder arthroplasty: patient-based and surgical risk factors. J Shoulder Elb Surg 24:24–30CrossRef Waterman BR, Dunn JC, Bader J, Urrea L, Schoenfeld AJ, Belmont PJ Jr (2015) Thirty-day morbidity and mortality after elective total shoulder arthroplasty: patient-based and surgical risk factors. J Shoulder Elb Surg 24:24–30CrossRef
9.
go back to reference Werner BC, Burrus MT, Begho I, Gwathmey FW, Brockmeier SF (2015) Early revision within 1 year after shoulder arthroplasty: patient factors and etiology. J Shoulder Elbow Surg 24(12):e323–e330CrossRefPubMed Werner BC, Burrus MT, Begho I, Gwathmey FW, Brockmeier SF (2015) Early revision within 1 year after shoulder arthroplasty: patient factors and etiology. J Shoulder Elbow Surg 24(12):e323–e330CrossRefPubMed
10.
go back to reference Husted H, Holm G, Jacobsen S (2008) Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients. Acta Orthop 79:168–173CrossRefPubMed Husted H, Holm G, Jacobsen S (2008) Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients. Acta Orthop 79:168–173CrossRefPubMed
11.
go back to reference Mathijssen NM, Verburg H, van Leeuwen CC, Molenaar TL, Hannink G (2016) Factors influencing length of hospital stay after primary total knee arthroplasty in a fast-track setting. Knee Surg Sports Traumatol Arthrosc 24(8):2692–2696CrossRefPubMed Mathijssen NM, Verburg H, van Leeuwen CC, Molenaar TL, Hannink G (2016) Factors influencing length of hospital stay after primary total knee arthroplasty in a fast-track setting. Knee Surg Sports Traumatol Arthrosc 24(8):2692–2696CrossRefPubMed
12.
go back to reference Vincent HK, Alfano AP, Lee L, Vincent KR (2006) Sex and age effects on outcomes of total hip arthroplasty after inpatient rehabilitation. Arch Phys Med Rehabil 87:461–467CrossRefPubMed Vincent HK, Alfano AP, Lee L, Vincent KR (2006) Sex and age effects on outcomes of total hip arthroplasty after inpatient rehabilitation. Arch Phys Med Rehabil 87:461–467CrossRefPubMed
13.
go back to reference Weaver F, Hynes D, Hopkinson W, Wixson R, Khuri S, Daley J, Henderson WG (2003) Preoperative risks and outcomes of hip and knee arthroplasty in the veterans health administration. J Arthroplast 18(6):693–708CrossRef Weaver F, Hynes D, Hopkinson W, Wixson R, Khuri S, Daley J, Henderson WG (2003) Preoperative risks and outcomes of hip and knee arthroplasty in the veterans health administration. J Arthroplast 18(6):693–708CrossRef
15.
go back to reference Elixhauser A, Steiner C, Harris DR, Coffey RM (1998) Comorbidity measures for use with administrative data. Med Care 36:8–27CrossRefPubMed Elixhauser A, Steiner C, Harris DR, Coffey RM (1998) Comorbidity measures for use with administrative data. Med Care 36:8–27CrossRefPubMed
16.
go back to reference Sharabiani MT, Aylin P, Bottle A (2012) Systematic review of comorbidity indices for administrative data. Med Care 50:1109–1118CrossRefPubMed Sharabiani MT, Aylin P, Bottle A (2012) Systematic review of comorbidity indices for administrative data. Med Care 50:1109–1118CrossRefPubMed
17.
go back to reference van Walraven C, Austin PC, Jennings A, Quan H, Forster AJ (2009) A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data. Med Care 47:626–633CrossRefPubMed van Walraven C, Austin PC, Jennings A, Quan H, Forster AJ (2009) A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data. Med Care 47:626–633CrossRefPubMed
18.
go back to reference Mantilla CB, Horlocker TT, Schroeder DR, Berry DJ, Brown DL (2002) Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty. Anesthesiology 96(5):1140–1146CrossRefPubMed Mantilla CB, Horlocker TT, Schroeder DR, Berry DJ, Brown DL (2002) Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty. Anesthesiology 96(5):1140–1146CrossRefPubMed
19.
go back to reference Santaguida PL, Hawker GA, Hudak PL, Glazier R, Mahomed NN, Kreder HJ, Coyte PC, Wright JG (2008) Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg 51(6):428–436PubMedPubMedCentral Santaguida PL, Hawker GA, Hudak PL, Glazier R, Mahomed NN, Kreder HJ, Coyte PC, Wright JG (2008) Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg 51(6):428–436PubMedPubMedCentral
20.
go back to reference Saltzman MD, Mercer DM, Warme WJ, Bertelsen AL, Matsen FA III (2010) Comparison of patients undergoing primary shoulder arthroplasty before and after the age of fifty. J Bone Joint Surg Am 92:42–47CrossRefPubMed Saltzman MD, Mercer DM, Warme WJ, Bertelsen AL, Matsen FA III (2010) Comparison of patients undergoing primary shoulder arthroplasty before and after the age of fifty. J Bone Joint Surg Am 92:42–47CrossRefPubMed
21.
go back to reference Court-Brown CM, Garg A, McQueen MM (2001) The epidemiology of proximal humeral fractures. Acta Orthop Scand 72(4):365–371CrossRefPubMed Court-Brown CM, Garg A, McQueen MM (2001) The epidemiology of proximal humeral fractures. Acta Orthop Scand 72(4):365–371CrossRefPubMed
22.
go back to reference Solberg BD, Moon CN, Franco DP, Paiement GD (2009) Surgical treatment of three and four-part proximal humeral fractures. J Bone Joint Surg Am 91(7):1689–1697CrossRefPubMed Solberg BD, Moon CN, Franco DP, Paiement GD (2009) Surgical treatment of three and four-part proximal humeral fractures. J Bone Joint Surg Am 91(7):1689–1697CrossRefPubMed
23.
go back to reference Han RJ, Sing DC, Feeley BT, Ma CB, Zhang AL (2016) Proximal humerus fragility fractures: recent trends in nonoperative and operative treatment in the Medicare population. J Shoulder Elb Surg 25(2):256–261CrossRef Han RJ, Sing DC, Feeley BT, Ma CB, Zhang AL (2016) Proximal humerus fragility fractures: recent trends in nonoperative and operative treatment in the Medicare population. J Shoulder Elb Surg 25(2):256–261CrossRef
24.
go back to reference Dunn JC, Lanzi J, Kusnezov N, Bader J, Waterman BR, Belmont PJ Jr (2015) Predictors of length of stay after elective total shoulder arthroplasty in the United States. J Shoulder Elb Surg 24:754–759CrossRef Dunn JC, Lanzi J, Kusnezov N, Bader J, Waterman BR, Belmont PJ Jr (2015) Predictors of length of stay after elective total shoulder arthroplasty in the United States. J Shoulder Elb Surg 24:754–759CrossRef
25.
go back to reference Davis DE, Paxton ES, Maltenfort M, Abboud J (2014) Factors affecting hospital charges after total shoulder arthroplasty: an evaluation of the National Inpatient Sample database. J Shoulder Elb Surg 23:1860–1866CrossRef Davis DE, Paxton ES, Maltenfort M, Abboud J (2014) Factors affecting hospital charges after total shoulder arthroplasty: an evaluation of the National Inpatient Sample database. J Shoulder Elb Surg 23:1860–1866CrossRef
Metadata
Title
The influence of gender on early adverse events, hospital charges and length of stay after shoulder arthroplasty
Authors
Bryan M. Saltzman
Bryce Basques
Timothy Leroux
Rachel M. Frank
Gregory P. Nicholson
Nikhil N. Verma
Anthony A. Romeo
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 1/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3547-6

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