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Perioperative medical optimization reduces morbidity and mortality risk after TSA
To decrease morbidity and mortality during total shoulder arthroplasty, careful perioperative medical optimization and efficient surgical techniques should be emphasized, according to study results.
Using the National Surgical Quality Improvement Program database, researchers retrospectively identified 2,004 patients who underwent primary total shoulder arthroplasty (TSA) between 2006 and 2011. The researchers stratified postoperative complications as major systemic, minor systemic, major local and minor local, and recorded mortality. Bivariable and multivariable analyses were used to derive odds ratios in order to express any associations between risk factors and clinical outcomes.
Results showed 46% of patients were obese and 48% had an American Society of Anesthesiologists classification of 3 or greater. The researchers found a 30-day mortality rate of 0.25% and a total complication rate of 3.64%. Independent predictors of mortality included comorbid cardiac disease and increasing chronologic age, whereas patients with peripheral vascular disease had a statistically significant increase in any complication.
According to study results, an independent predictor for the development of a major local complication was operative time of more than 174 minutes. After controlling for other variables, the researchers found no association between obesity and any specified complication. – by Casey Tingle
Disclosure: The authors have no relevant financial disclosures.