Readmission after shoulder arthroplasty

Mahoney, Andrew P.; Bosco, Joseph; Zuckerman, Joseph D.

doi:10.1016/j.jse.2013.08.007

Cited by 76 publications

(42 citation statements)

References 17 publications

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“…Day-of-surgery admission rates were five to ten times lower in our study than in previous studies. Thirty-day readmission rates were reported to be approximately 5% in ambulatory orthopedic surgery, [36][37][38] compared with 1% in our study. This may partly reflect the systems-based, multidisciplinary approach instituted in our centre, which includes routine post-discharge follow up.…”

Section: Discussioncontrasting

confidence: 50%

Association of peripheral nerve blocks with postoperative outcomes in ambulatory shoulder surgery patients: a single-centre matched-cohort study

Hamilton

Ramlogan

Lui

et al. 2018

Can J Anesth/J Can Anesth

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Purpose Regional anesthesia may have immediate postoperative advantages compared with general anesthesia, but its impact on post-discharge outcomes is poorly described. Our objective was to measure the association between regional anesthesia and outcomes after ambulatory shoulder surgery. Methods We conducted a historical cohort study at The Ottawa Hospital. Adults C 18 yr old having elective ambulatory shoulder surgery from January 1, 2011 to December 31, 2016 were included. Using one-to-many coarsened exact matching (CEM) to adjust for potential confounders, we matched peripheral nerve block (PNB) patients to those without a PNB. Within the matched cohort, we assessed whether PNBs were associated with our primary composite outcomes, comprising unplanned admissions, emergency department visits, readmissions, or death within 30 days of surgery. Results There were 1,623 patients who met the inclusion criteria; PNBs were placed in 1,382 (85.2%) patients. CEM matched 211 patients who did not receive a PNB to 950 patients with similar characteristics who did receive a PNB (n = 1,161; 71.5% of total cohort). In patients who received a PNB compared with those who had no PNB, there was no difference in risk of composite outcome (relative risk, 1.58; 95% confidence interval [CI], 0.83 to 3.01), or hospital costs (ratio of means 0.73; 95% CI, 0.21 to 2.49). Conclusion Peripheral nerve blocks in ambulatory shoulder surgery were not associated with a significant difference in a composite of adverse postoperative outcomes. Nevertheless, given the lower than expected incidence and moderate effect size associating PNBs with post-discharge events, future large prospective trials are needed to assess post-discharge outcomes. Trial registration www.clinicaltrials.gov (NCT03309 644). Registered 13 October 2017.

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Section: Discussioncontrasting

confidence: 50%

Association of peripheral nerve blocks with postoperative outcomes in ambulatory shoulder surgery patients: a single-centre matched-cohort study

Hamilton

Ramlogan

Lui

et al. 2018

Can J Anesth/J Can Anesth

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“…Les taux varient de 3,8 à 8 % selon le type de chirurgie : pour la chirurgie rachidienne [13] (3,8 %), l'arthroplastie totale du genou [17] (8 %), de la hanche [16] (5 %) ou de l'épaule [12] (5,9 %). Les taux varient de 3,8 à 8 % selon le type de chirurgie : pour la chirurgie rachidienne [13] (3,8 %), l'arthroplastie totale du genou [17] (8 %), de la hanche [16] (5 %) ou de l'épaule [12] (5,9 %).…”

Section: Discussionunclassified

“…En chirurgie orthopédique, les principaux articles sur le sujet traitent majoritairement des réadmissions précoces (dans les 30 à 90 jours) après prothèse articulaire [11][12][13] par le biais de registres ou d'études de cohorte spécifiques. Une étude a récemment évalué les causes de réadmission dans les 30 jours après tous types d'interventions chirurgicales pratiquées au sein d'un même service d'orthopédie [14].…”

Section: Introductionunclassified

Les réinterventions chirurgicales imprévues sont-elles un indicateur pertinent de qualité et de gestion des risques en chirurgie orthopédique ?

Pujol

Merrer

Lemaire

et al. 2015

Revue de Chirurgie Orthopédique et Traumatologique

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“…The federal government has also been trying to control health care costs through nonreimbursable "never events," and decreasing payment for readmissions within 30 days after joint arthroplasty. [7][8][9] Expansion of all these measures to more areas of orthopaedic surgery, inpatient and outpatient, along with the participation of private insurance companies should be anticipated. 9 Because the government has decided complications in the first 30 days after surgery will be their measure for quality of care, efforts to decrease complications during the 30-day perioperative period should be a major focus.…”

Section: See Related Article On Page 1158mentioning

confidence: 99%

Editorial Commentary: Complications of Shoulder Rotator Cuff Repair Are Relevant in Modern Health Care

Voloshin

2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Understanding the type and rate of complications after shoulder rotator cuff repair could help surgeons to focus their quality improvement efforts. This is of great current relevance because value in health care is defined as the ratio of outcomes over cost, and complications increase cost significantly. A particular focus could be on lowering the rate of complications associated with "riskier" patients and "riskier" surgical techniques.

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Readmission after shoulder arthroplasty

Cited by 76 publications

References 17 publications

Association of peripheral nerve blocks with postoperative outcomes in ambulatory shoulder surgery patients: a single-centre matched-cohort study

Association of peripheral nerve blocks with postoperative outcomes in ambulatory shoulder surgery patients: a single-centre matched-cohort study

Les réinterventions chirurgicales imprévues sont-elles un indicateur pertinent de qualité et de gestion des risques en chirurgie orthopédique ?

Editorial Commentary: Complications of Shoulder Rotator Cuff Repair Are Relevant in Modern Health Care

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