The impact of age on 30-day complications following shoulder instability surgery
| Autor: | Christopher S. Ahmad, Charles M. Jobin, Venkat Boddapati, David Kovacevic, William N. Levine, Ajay S. Padaki, T. Sean Lynch |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Joint Instability Male medicine.medical_specialty Time Factors Multivariate analysis Databases Factual medicine.medical_treatment Operative Time Comorbidity Patient Readmission Arthroscopy Young Adult 03 medical and health sciences 0302 clinical medicine Recurrence medicine Humans Orthopedic Procedures Orthopedics and Sports Medicine Bankart repair Retrospective Studies 030222 orthopedics Shoulder Joint business.industry Glenohumeral instability Shoulder Dislocation Age Factors Arthroscopic Bankart repair 030229 sport sciences General Medicine United States Surgery Hospitalization Treatment Outcome Hospital admission Cohort Shoulder instability Female Complication business |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 29:e462-e467 |
| ISSN: | 1058-2746 |
| DOI: | 10.1016/j.jse.2020.05.024 |
| Popis: | The purpose of this study was to evaluate short-term outcomes including medical complications, overnight admission, and 30-day readmission with regard to patient age at the time of shoulder instability surgery.Patients undergoing surgery for glenohumeral instability were collected from the National Surgical Quality Improvement Program between the years of 2005 and 2016. These patients were separated into cohorts of younger than 25 years, 25-34 years, and older than 34 years. Medical complications, hospital admission, and 30-day readmission were compared using multivariate analysis.Of the 5449 patients included, there were 2035 (37.0%) patients younger than 25 years, 1815 (33.0%) between 25 and 34 years, and 1649 (30.0%) 35 and older. Overall, 81.7% of patients underwent an arthroscopic Bankart repair, 12.6% of patients underwent an open Bankart repair, and 5.7% of patients underwent a Latarjet-Bristow procedure. The risk of 30-day readmission increased with age, ranging from 0.24% for25 years old to 0.92% for 35 years and older (P = .040). Operative duration greater than 60 minutes (odds ratio [OR] 1.76; P = .001), duration greater than 90 minutes (OR 3.58; P.001), and American Society of Anesthesiologists class III and IV (OR 1.80; P = .001) were associated with increased risk of overnight hospital stay. Compared with arthroscopic Bankart repair, the Latarjet-Bristow procedure was associated with increased total complications (OR 3.30; P = .021), overnight hospital stay (OR 4.64; P.001), and 30-day readmission (OR 3.39; P = .013).This study demonstrates that even in the relatively young and healthy shoulder instability patient cohort, patients older than 25 years are almost 4 times more likely to experience a complication. Additionally, Latarjet-Bristow procedures are 3-4 times more likely to experience a complication or readmission than other shoulder instability procedures. |
| Databáze: | OpenAIRE |
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