Perioperative complications and readmission rates following total shoulder arthroplasty in patients aged 90 and older.

Abstract

Background: Previous literature has cited age as an independent risk factor for surgical outcomes following total shoulder arthroplasty (TSA). The purpose of this study is to determine the short-term outcomes of nonagenarians following primary TSA and compare them to younger cohorts.

Methods: The Nationwide Readmission Database (NRD) was queried from 2010 to 2020 to identify patients who underwent a primary reverse or anatomic TSA (rTSA or aTSA). Cohorts were defined by those aged 70-74 (septuagenarians), 80-84 (octogenarians), or 90 and over (nonagenarians). The septuagenarians and octogenarians were matched 1:1 to the nonagenarians by the Charlson-Deyo Comorbidity Index (CCI), year of procedure, and sex. Length of hospital stay, readmission rate, and postoperative outcomes were collected.

Results: Length of hospital stay, in-hospital death, 180-day mortality, 180-day readmission, and rate of medical complications were highest in the nonagenarians. Rates of periprosthetic fracture were highest in the nonagenarians. The number of total surgical complications was not significantly different between cohorts. The rate of revision within 180 days and discharge to rehabilitation facility was not significantly different between the three groups.

Discussion: The nonagenarians are at an increased risk of medical complications, longer hospital stays, periprosthetic fractures, and death following TSA. Otherwise, nonagenarians have similar rates of total surgical complications to the septuagenarians and octogenarians.