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ASA classification, cardiac disease linked with increased readmission risk after total shoulder arthroplasty
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Recently published results showed patients who underwent total shoulder arthroplasty had an increased likelihood of readmission if they had an American Society of Anesthesiologists classification of three or greater and a history of cardiac disease.
Brian R. Waterman, MD, and colleagues used bivariate logistic regression analysis to determine the effect of patient variables, surgical factors and complications on hospital readmission among 3,547 patients who underwent total shoulder arthroplasty between 2011 and 2013.
Results showed a 30-day readmission rate of 2.9%, with 34% of patients with any complications readmitted. Researchers noted a strong association between perioperative complications and an increased risk of readmission. According to results, pulmonary embolism, postoperative sepsis, cardiac arrest requiring cardiopulmonary resuscitation, deep venous thrombosis, progressive renal insufficiency, periprosthetic infection and wound dehiscence had readmission rates that approximated or exceeded 50%.
Preoperative surgical characteristics that predicted hospital readmission included American Society of Anesthesiologists (ASA) classification of three or greater and a history of cardiac arrest, according to results of a multivariate logistic regression analysis. Researchers found periprosthetic joint infection, myocardial infarction, pulmonary embolism, deep venous thrombosis and urinary tract infection were individual postoperative complications that had a significant association with hospital readmission. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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