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Outpatient TSA seen as safe, cost-effective in appropriately selected patients
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Recently published results of a level 3 study showed patients who underwent outpatient and inpatient total shoulder arthroplasty had no significant differences in 30-day adverse event and readmission rates.
Researchers categorized 7,197 patients who underwent primary total shoulder arthroplasty (TSA) between 2005 and 2014 into an outpatient TSA group (n=173) or an inpatient TSA group (n=7,024). Researchers collected patient and procedure characteristics, and calculated 30-day adverse event and readmission rates for each cohort.
Results showed significant differences in patient characteristics between the outpatient and inpatient group, with the outpatient cohort being significantly younger; having a significantly higher proportion of male patients; significantly lower American Society of Anesthesiologists (ASA) scores; significantly lower BMI scores; and significantly lower rates of pulmonary disease and hypertension. Researchers also noted a significantly greater number of patients in the inpatient group received general anesthesia, while operative times were significantly shorted in the outpatient group.
Of adverse events that occurred 30 days of TSA, four events occurred in the outpatient cohort vs. 554 events in the inpatient cohort. Multivariate logistic regression showed no significant difference in the odds of readmission between the inpatient and outpatient groups. Researchers noted pneumonia, implant instability, pulmonary embolism, deep wound infection and hematoma were the most common reasons for readmission across the entire group after TSA. – by Casey Tingle
Disclosures: Leroux reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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