Risk factors for unexpected readmission and reoperation following open procedures for shoulder instability: a national database study of 1,942 cases.

IF 1.8 Q2 ORTHOPEDICS Clinics in Shoulder and Elbow Pub Date : 2023-09-01 DOI:10.5397/cise.2023.00178
John M Tarazi, Matthew J Partan, Alton Daley, Brandon Klein, Luke Bartlett, Randy M Cohn
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Abstract

Background: The purpose of this study was to identify demographics and risk factors associated with unplanned 30-day readmission and reoperation following open procedures for shoulder instability and examine recent trends in open shoulder instability procedures.

Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 23455, 23460, and 23462 to find patients who underwent shoulder instability surgery from 2015 to 2019. Independent sample Student t-tests and chi-square tests were used in univariate analyses to identify demographic, lifestyle, and perioperative variables related to 30-day readmission following repair for shoulder instability. Multivariate logistic regression modeling was subsequently performed.

Results: In total, 1,942 cases of open surgical procedures for shoulder instability were identified. Within our study sample, 1.27% of patients were readmitted within 30 days of surgery, and 0.85% required reoperation. Multivariate logistic regression modeling confirmed that the following patient variables were associated with a statistically significant increase in the odds of readmission: open anterior bone block/Latarjet-Bristow procedure, being a current smoker, and a long hospital stay (all P<0.05). Multivariate logistic regression modeling confirmed statistically significant increased odds of reoperation with an open anterior bone block or Latarjet-Bristow procedure (P<0.05).

Conclusions: Unplanned 30-day readmission and reoperation after open shoulder instability surgery is infrequent. Patients who are current smokers, have an open anterior bone block or Latarjet-Bristow procedure, or a longer than average hospital stay have higher odds of readmission than others. Patients who undergo an open anterior bone block or Latarjet-Bristow procedure have higher odds of reoperation than those who undergo an open soft-tissue procedure. Level of evidence: III.

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肩部不稳定开放性手术后意外再入院和再手术的危险因素:一项1942例国家数据库研究。
背景:本研究的目的是确定肩部不稳定开放手术后意外30天再入院和再手术相关的人口统计学和危险因素,并研究肩部不稳定开放手术的最新趋势。方法:使用现行程序术语(CPT)代码23455,23460和23462查询美国外科医师学会国家手术质量改进计划(ACS-NSQIP)数据库,以查找2015年至2019年接受肩部不稳定手术的患者。独立样本学生t检验和卡方检验用于单变量分析,以确定与肩部不稳定修复后30天再入院相关的人口统计学、生活方式和围手术期变量。随后进行多元逻辑回归建模。结果:共有1,942例肩部不稳的开放性手术被确定。在我们的研究样本中,1.27%的患者在手术30天内再次入院,0.85%的患者需要再次手术。多因素logistic回归模型证实,以下患者变量与再入院几率的统计学显著增加相关:开放前骨阻滞/ latarjet - bristol手术,当前吸烟者和长时间住院(所有p结论:开放肩关节不稳定手术后意外30天再入院和再手术并不常见。目前吸烟者,接受过开放性前骨阻滞或latarjet - bristol手术,或住院时间超过平均时间的患者再入院的几率高于其他患者。接受开放性前骨阻滞或Latarjet-Bristow手术的患者比接受开放性软组织手术的患者有更高的再手术几率。证据水平:III。
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CiteScore
0.30
自引率
0.00%
发文量
55
审稿时长
15 weeks
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