Increase in outpatient TSA yielded reduced length of stay, readmission rates
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CHICAGO — The rate of outpatient total shoulder arthroplasty increased during the COVID-19 pandemic, with a reduction in length of stay and 90-day readmission rates, according to results presented here.
Abhijit Seetharam, MD, and colleagues separated 567 patients who underwent anatomic or reverse TSA into two groups based on whether they underwent surgery between January 2018 and March 2020 (defined as the era before COVID-19) or from March 2020 to January 2021 (the COVID-19 era). Researchers performed a chart review and collected demographic data and medical comorbidities.
“The outcome we were looking at was the surgery type. Outpatient surgery, we considered as same-day discharge,” Seetharam said in his presentation during the American Shoulder and Elbow Surgeons Specialty Day at the American Academy of Orthopaedic Surgeons Annual Meeting. “So, any patients who stayed overnight were put into the inpatient [group].”
He added they also assessed length of stay and 90-day complication rates, including rates of readmissions, ER visits, venous thromboembolism and infection.
“We had a higher rate of outpatient cases during our COVID-19 era, so 32% compared to a 6% rate of outpatient cases in our pre-COVID era, which was statistically significant,” Seetharam said.
Seetharam noted they found no significant differences in the type of total shoulder replacement performed and the type of anesthesia used between the group before the COVID-19 era and COVID-19 era group. Patients who underwent surgery in the COVID-19 era had a significant reduction in length of stay, which Seetharam noted correlated with the increase in outpatient cases during this time. He added patients who underwent surgery in the COVID-19 era also had a statistically significant reduction in 90-day readmission rates.
“As far as ER visits, infections, [venous thromboembolism and] early complications, [there was] no significant difference in any rates of any of those between the two eras,” Seetharam said.
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Seetharam A, et al. Paper 9. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 22-26, 2022; Chicago.
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