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Several factors associated with hospital admission after arthroscopic Bankart repair
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Female gender, increasing age and longer operation time were independent risk factors for hospital admission following arthroscopic Bankart repair, according to results published in Orthopedics.
“While arthroscopic Bankart repair is commonly performed in the outpatient setting in a safe fashion among young healthy patients, older patients with comorbidities, such as diabetes and longer operation times, had a significant higher hospital admission rate,” Brett D. Owens, MD, told Healio.com/Orthopedics.
Using the American College of Surgeons National Surgical Quality Improvement Program prospective database, Owens and colleagues performed univariate analysis and binary logistic regression to determine risk factors for hospital admission among 2,291 patients who underwent arthroscopic Bankart repair between 2005 and 2014.
Results showed 7.6% of patients required inpatient hospital admission following surgery, with univariate analysis showing female gender, age older than 40 years, white race, BMI greater than 30 kg/m2 and American Society of Anesthesiologists class greater than 3 to be associated with admission. Independent predictors of admission included female gender, increasing age, diabetes and longer operative time, according to results of a multivariate analysis. – by Casey Tingle
Disclosures: Owens reports he is a paid consultant for Mitek and MTF/Conmed. Please see the full study for a list of all other authors’ relevant financial disclosures.
Perspective
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Rachel M. Frank, MD
The study “Risk factors for hospital admission following arthroscopic Bankart repair” by DeFroda and colleagues identifies several risk factors for inpatient hospital admission following arthroscopic shoulder stabilization, including diabetes, female sex, longer operative time and increasing patient age. Notably, of these factors, female sex and diabetes were the only statistically significant variables.
Of the 2,291 patients captured in the NSQIP database undergoing arthroscopic shoulder stabilization, nearly 8% required admission to the hospital following surgery. This rate is higher than what might be expected for a routine, outpatient arthroscopic procedure, and this study is certainly helpful for surgeons to better understand which patients may be at higher risk for admission after surgery, and further, will help surgeons counsel those patients appropriately.
Importantly, it is unclear if any of the patients who were admitted following surgery “planned” admissions, as that is a limitation of the NSQIP database. Further, as the authors mention, the NSQIP database does not capture procedures performed in independent surgery centers, which may potentially result in an overestimation of the inpatient admission rate. As patients undergoing outpatient surgery in independent surgery centers are generally required to be healthy enough to be discharged home on a consistent basis following surgery, the data captured in NSQIP may over-represent patients who are, by comparison, less healthy and thus may be more likely to require admission.
Overall, this is a study that provides important data and is helpful for surgeons performing arthroscopic Bankart repair.
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