John M Tarazi, Matthew J Partan, Alton Daley, Brandon Klein, Luke Bartlett, Randy M Cohn
{"title":"肩部不稳定开放性手术后意外再入院和再手术的危险因素:一项1942例国家数据库研究。","authors":"John M Tarazi, Matthew J Partan, Alton Daley, Brandon Klein, Luke Bartlett, Randy M Cohn","doi":"10.5397/cise.2023.00178","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to identify demographics and risk factors associated with unplanned 30-day readmission and reoperation following open procedures for shoulder instability and examine recent trends in open shoulder instability procedures.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 23455, 23460, and 23462 to find patients who underwent shoulder instability surgery from 2015 to 2019. Independent sample Student t-tests and chi-square tests were used in univariate analyses to identify demographic, lifestyle, and perioperative variables related to 30-day readmission following repair for shoulder instability. Multivariate logistic regression modeling was subsequently performed.</p><p><strong>Results: </strong>In total, 1,942 cases of open surgical procedures for shoulder instability were identified. Within our study sample, 1.27% of patients were readmitted within 30 days of surgery, and 0.85% required reoperation. Multivariate logistic regression modeling confirmed that the following patient variables were associated with a statistically significant increase in the odds of readmission: open anterior bone block/Latarjet-Bristow procedure, being a current smoker, and a long hospital stay (all P<0.05). Multivariate logistic regression modeling confirmed statistically significant increased odds of reoperation with an open anterior bone block or Latarjet-Bristow procedure (P<0.05).</p><p><strong>Conclusions: </strong>Unplanned 30-day readmission and reoperation after open shoulder instability surgery is infrequent. Patients who are current smokers, have an open anterior bone block or Latarjet-Bristow procedure, or a longer than average hospital stay have higher odds of readmission than others. Patients who undergo an open anterior bone block or Latarjet-Bristow procedure have higher odds of reoperation than those who undergo an open soft-tissue procedure. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"252-259"},"PeriodicalIF":1.8000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/5f/cise-2023-00178.PMC10497916.pdf","citationCount":"0","resultStr":"{\"title\":\"Risk factors for unexpected readmission and reoperation following open procedures for shoulder instability: a national database study of 1,942 cases.\",\"authors\":\"John M Tarazi, Matthew J Partan, Alton Daley, Brandon Klein, Luke Bartlett, Randy M Cohn\",\"doi\":\"10.5397/cise.2023.00178\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The purpose of this study was to identify demographics and risk factors associated with unplanned 30-day readmission and reoperation following open procedures for shoulder instability and examine recent trends in open shoulder instability procedures.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 23455, 23460, and 23462 to find patients who underwent shoulder instability surgery from 2015 to 2019. Independent sample Student t-tests and chi-square tests were used in univariate analyses to identify demographic, lifestyle, and perioperative variables related to 30-day readmission following repair for shoulder instability. Multivariate logistic regression modeling was subsequently performed.</p><p><strong>Results: </strong>In total, 1,942 cases of open surgical procedures for shoulder instability were identified. Within our study sample, 1.27% of patients were readmitted within 30 days of surgery, and 0.85% required reoperation. Multivariate logistic regression modeling confirmed that the following patient variables were associated with a statistically significant increase in the odds of readmission: open anterior bone block/Latarjet-Bristow procedure, being a current smoker, and a long hospital stay (all P<0.05). Multivariate logistic regression modeling confirmed statistically significant increased odds of reoperation with an open anterior bone block or Latarjet-Bristow procedure (P<0.05).</p><p><strong>Conclusions: </strong>Unplanned 30-day readmission and reoperation after open shoulder instability surgery is infrequent. Patients who are current smokers, have an open anterior bone block or Latarjet-Bristow procedure, or a longer than average hospital stay have higher odds of readmission than others. Patients who undergo an open anterior bone block or Latarjet-Bristow procedure have higher odds of reoperation than those who undergo an open soft-tissue procedure. Level of evidence: III.</p>\",\"PeriodicalId\":33981,\"journal\":{\"name\":\"Clinics in Shoulder and Elbow\",\"volume\":\"26 3\",\"pages\":\"252-259\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/5f/cise-2023-00178.PMC10497916.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinics in Shoulder and Elbow\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5397/cise.2023.00178\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinics in Shoulder and Elbow","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5397/cise.2023.00178","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Risk factors for unexpected readmission and reoperation following open procedures for shoulder instability: a national database study of 1,942 cases.
Background: The purpose of this study was to identify demographics and risk factors associated with unplanned 30-day readmission and reoperation following open procedures for shoulder instability and examine recent trends in open shoulder instability procedures.
Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 23455, 23460, and 23462 to find patients who underwent shoulder instability surgery from 2015 to 2019. Independent sample Student t-tests and chi-square tests were used in univariate analyses to identify demographic, lifestyle, and perioperative variables related to 30-day readmission following repair for shoulder instability. Multivariate logistic regression modeling was subsequently performed.
Results: In total, 1,942 cases of open surgical procedures for shoulder instability were identified. Within our study sample, 1.27% of patients were readmitted within 30 days of surgery, and 0.85% required reoperation. Multivariate logistic regression modeling confirmed that the following patient variables were associated with a statistically significant increase in the odds of readmission: open anterior bone block/Latarjet-Bristow procedure, being a current smoker, and a long hospital stay (all P<0.05). Multivariate logistic regression modeling confirmed statistically significant increased odds of reoperation with an open anterior bone block or Latarjet-Bristow procedure (P<0.05).
Conclusions: Unplanned 30-day readmission and reoperation after open shoulder instability surgery is infrequent. Patients who are current smokers, have an open anterior bone block or Latarjet-Bristow procedure, or a longer than average hospital stay have higher odds of readmission than others. Patients who undergo an open anterior bone block or Latarjet-Bristow procedure have higher odds of reoperation than those who undergo an open soft-tissue procedure. Level of evidence: III.