Predictors of extended length of stay after elective shoulder arthroplasty

Menendez, Mariano E.; Baker, Dawn; Fryberger, Charles T.; Ponce, Brent A.

doi:10.1016/j.jse.2015.02.014

Cited by 99 publications

(54 citation statements)

References 39 publications

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“…4 Last, 2 large epidemiologic studies of TSA in the United States indicated that women have a significantly longer postoperative length of stay. 2,11 In addition to the effects of gender, there is also increasing evidence that the patient's expectations are measurable and have an effect on outcomes. Henn et al showed in rotator cuff repairs that patients' preoperative expectations correlated with self-assessed outcomes.…”

mentioning

confidence: 99%

Gender differences in expectations and outcomes for total shoulder arthroplasty: a prospective cohort study

Jawa

Dasti

Brown

et al. 2016

Journal of Shoulder and Elbow Surgery

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mentioning

confidence: 99%

Gender differences in expectations and outcomes for total shoulder arthroplasty: a prospective cohort study

Jawa

Dasti

Brown

et al. 2016

Journal of Shoulder and Elbow Surgery

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“…It is notable that the population is aging and older patients are the most likely to benefit from RSA [13]. However, the average hospital cost for shoulder arthroplasty is estimated to be $17,000 [14].…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, it is important to find a solution to reduce the overall costs to provide continued access to RSA. LOS has recently been analyzed after shoulder arthroplasty in women, seniors, and comorbidity patients, with insurance coverage and diagnosis significantly contributing to increase in LOS [13, 15, 16]. In addition, hospital volume and surgeon experience have been associated with a lower LOS and cost compared to lower volume facilities and surgeons [17].…”

Section: Discussionmentioning

confidence: 99%

Subscapularis- and deltoid-sparing vs traditional deltopectoral approach in reverse shoulder arthroplasty: a prospective case-control study

et al. 2017

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BackgroundWith the growth of reverse shoulder arthroplasty (RSA), it is becoming increasingly necessary to establish the most cost-effective methods for the procedure. The surgical approach is one factor that may influence the cost and outcome of RSA. The purpose of this study was to compare the clinical results of a subscapularis- and deltoid-sparing (SSCS) approach to a traditional deltopectoral (TDP) approach for RSA. The hypothesis was that the SSCS approach would be associated with decreased length of stay (LOS), equal complication rate, and better short-term outcomes compared to the TDP approach.MethodsA prospective evaluation was performed on patients undergoing RSA over a 2-year period. A deltopectoral incision was used followed by either an SSCS approach or a traditional tenotomy of the subscapularis (TDP). LOS, adverse events, physical therapy utilization, and patient satisfaction were collected in the 12 months following RSA.ResultsLOS was shorter with the SSCS approach compared to the TDP approach (from 8.2 ± 6.4 days to 15.2 ± 11.9 days; P = 0.04). At 3 months postoperative, the single assessment numeric evaluation score (80 ± 11% vs 70 ± 6%; P = 0.04) and active elevation (130 ± 22° vs 109 ± 24°; P = 0.01) were higher in the SSCS group. The SSCS approach resulted in a net cost savings of $5900 per patient. Postoperative physical therapy, pain levels, and patient satisfaction were comparable in both groups. No immediate intraoperative complications were noted.ConclusionUsing a SSCS approach is an option for patients requiring RSA. Overall LOS is minimized compared to a TDP approach with subscapularis tenotomy. The SSCS approach may provide substantial healthcare cost savings, without increasing complication rate or decreasing patient satisfaction.

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“…Numerous studies have shown that patients without severe medical comorbidities typically have shorter LOS across several subdisciplines in orthopedics. [18][19][20][21][22][23] However, in addition to patient selection, there are other hospitalspecific variables that may contribute to the shorter LOS. Because the only patients at the authors' OSH are orthopedic in nature, the nursing staff follows similar, evidencebased pathways for all patients undergoing specific procedures.…”

Section: Discussionmentioning

confidence: 99%

An Assessment of the Safety of an Orthopedic Specialty Hospital: A 5-Year Experience

Padegimas¹,

Ramsey²,

Austin³

et al. 2017

Orthopedics

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One of the goals of orthopedic specialty hospitals is to provide safe and efficient care to medically optimized patients. The authors' orthopedic specialty hospital is a physician-owned, 24-bed facility that accommodates a multispecialty orthopedic practice in the areas of spine, hip and knee arthroplasty, shoulder and elbow, sports, foot and ankle, and hand surgery. The purpose of this study was to examine the first 5 years of an institutional experience with an orthopedic specialty hospital and to determine if any procedures were at increased risk of postoperative transfer. When higher-level emergency treatment was required, patients were appropriately and expeditiously transferred and treated at an acute care facility. Length of stay compared favorably with that in traditional acute care hospitals. The specialty hospital may be an appropriate model for delivery of care to medically screened patients in the United States. [Orthopedics. 2017; 40(4):223-229.].

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Predictors of extended length of stay after elective shoulder arthroplasty

Cited by 99 publications

References 39 publications

Gender differences in expectations and outcomes for total shoulder arthroplasty: a prospective cohort study

Gender differences in expectations and outcomes for total shoulder arthroplasty: a prospective cohort study

Subscapularis- and deltoid-sparing vs traditional deltopectoral approach in reverse shoulder arthroplasty: a prospective case-control study

An Assessment of the Safety of an Orthopedic Specialty Hospital: A 5-Year Experience

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