Underrepresented groups may be less likely to undergo RSA for proximal humeral fractures
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Key takeaways:
- Underrepresented groups may be less likely to get reverse shoulder arthroplasty for humerus fractures vs. white patients.
- Underrepresented groups were more likely to undergo open reduction and internal fixation.
Published results showed underrepresented groups may be less likely to undergo reverse shoulder arthroplasty for proximal humerus fractures compared with white patients.
“This finding suggests there may be racial disparities in the selection of operative modality for proximal humerus fractures,” Ryan T. Halvorson, MD, a clinical resident in the department of orthopedic surgery at the University of California San Francisco, and colleagues wrote in the study.
Halvorson and colleagues used the National Surgical Quality Improvement Program database to analyze data from 7,499 patients who underwent surgical treatment for a proximal humeral fracture.
Overall, 5,011 patients (67%) underwent open reduction and internal fixation (ORIF), 1,962 patients (26%) underwent RSA and 526 patients (7%) underwent hemiarthroplasty. Halvorson and colleagues noted utilization of RSA for proximal humeral fractures increased from 0% in 2006 to 34% in 2020. Among patients who underwent RSA, 27% were white, 21% were Black, 15% were Asian and 15% were Native American or Native Alaskan.
After multivariable analysis, Halvorson and colleagues found underrepresented groups (OR = 0.75) and male patients (OR = 0.77) had significantly lower odds of receiving RSA compared with ORIF. They also found patients older than 65 years, patients with high American Society of Anesthesiologists classification and patients who were overweight or obese had significantly higher odds of receiving RSA compared with ORIF.
“While patient factors such as age, BMI and comorbidities are known to directly impact outcomes and thus may be predictive of the type of surgical intervention, patient race should not dictate treatment,” Halvorson and colleagues concluded.
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