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. 2019 Mar 12;3(1):54-58.
doi: 10.1016/j.jses.2018.11.002. eCollection 2019 Mar.

Ninety-day readmissions following reverse total shoulder arthroplasty

Kelly L Scott  1 , Andrew S Chung  1 , Justin L Makovicka  1 , Austin J Pena  2 , Varun Arvind  3 , Steven J Hattrup  1
Affiliations

Ninety-day readmissions following reverse total shoulder arthroplasty

Kelly L Scott et al. JSES Open Access. .

Abstract

Background: An adequate characterization of 90-day readmissions after primary reverse total shoulder arthroplasty (RTSA) on a national level remains to be undertaken. As bundled payment models become more prevalent, an improved understanding of readmission data will help to predict resource utilization and expenses.

Methods: All adult patients who underwent elective primary RTSA in 2014 in the National Readmission Database were included in the analysis. Two cohorts were created based on 90-day readmission status. Multivariate analysis was then performed to determine predictors of 90-day readmissions. Reasons for 30-, 60-, and 90-day readmissions were identified. Total hospital resource utilization was calculated.

Results: An estimated 25,196 patients were identified. The 30-, 60-, and 90-day rates of readmissions were 0.6%, 1.2%, and 1.7%, respectively. Diabetes (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.14-1.78), hypertension (OR, 1.63; 95% CI, 1.28-2.08), paralysis (OR, 3.61; 95% CI, 1.63-7.97), and solid tumor without metastasis (OR, 2.72; 95% CI, 1.21-6.12) were identified as independent predictors of 90-day readmission. Ninety-day readmissions were associated with a significant increase in cost (P = .02). The most common related reason for 90-day readmission was hardware-related complications at all time points.

Conclusion: Although uncommon, 90-day readmissions after primary RTSA are associated with significant patient morbidity and consequently substantial hospital costs.

Keywords: 90-day outcomes; Reverse shoulder arthroplasty; complications; cost; primary; readmission.

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