2012年至2020年解剖和反向全肩关节置换术的人口统计学、合并症和护理时间趋势

Q4 Medicine

Seminars in Arthroplasty Pub Date : 2025-05-26 DOI:10.1053/j.sart.2025.04.008

Victoria E. Bindi BS , Timothy R. Buchanan BS , Robert J. Cueto MD , Keegan M. Hones MD, MS , Joseph J. King MD , Thomas W. Wright MD , Bradley S. Schoch MD , Kevin A. Hao MD

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引用次数: 0

摘要

本研究的目的是描述2012年至2020年期间接受初级选择性解剖和反向全肩关节置换术的患者的人口统计学特征、合并症和护理结局的趋势。方法查询美国外科医师学会国家手术质量改进项目数据库，以确定2012年至2020年期间接受初级选择性解剖和反向全肩关节置换术的患者的人口统计学特征、合并症和护理结果（n = 32,112）。分别采用线性回归和Cochran-Armitage趋势检验评估连续变量和分类变量的趋势。结果在研究期间，60 ~ 80岁患者接受选择性全肩关节置换术（TSA）的比例增加，而≤60岁和80岁患者的比例下降(P <；措施)。择期TSA患者有肥胖增加的趋势（P = 0.008）。在研究期间，白人患者接受选择性TSA的比例有所减少，而少数民族患者的比例则相应增加(P <；措施)。美国麻醉医师协会身体状况评分≥3分的患者比例总体上有所增加(P <；.001)和心力衰竭史（P = .014）。相反，高血压患者需要药物治疗和接受透析治疗的比例下降（P = 0.038和P = 0.006）。在研究期间，30天医疗并发症的发生率从8.5%下降到4.5% (P <；措施)。结论在研究期间（2012-2020年），尽管择期TSA患者的医疗复杂性和多样性不断增加，但术后30天的医疗并发症发生率有所下降。这些发现证明了选择性TSA患者护理的改善。补偿调整应反映患者医疗复杂性的增加，需要重新评估框架，以配合不断变化的保健模式和资源需求。

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Temporal trends in demographic, comorbidity, and episode-of-care in anatomic and reverse total shoulder arthroplasty from 2012 to 2020

Background

The purpose of this study was to characterize trends in the demographic characteristics, comorbidities, and episode-of-care outcomes for patients who underwent primary elective anatomic and reverse total shoulder arthroplasty between 2012 and 2020.

Methods

The American College of Surgeons National Surgical Quality Improvement Project database was queried to identify patient demographic characteristics, comorbidities, and episode-of-care outcomes for patients who underwent primary elective anatomic and reverse total shoulder arthroplasty between 2012 and 2020 (n = 32,112). Trends in continuous and categorical variables were evaluated using linear regression and the Cochran-Armitage trend test, respectively.

Results

Over the study period, the proportion of patients ages 60-80 years undergoing elective total shoulder arthroplasty (TSA) increased, while patients ≤60 and >80 years decreased (P < .001). There was a trend towards increasing obesity in patients undergoing elective TSA (P = .008). There was a reduction in the proportion of white patients undergoing elective TSA, with a concomitant increase in minority patients during the study period (P < .001). There was an overall increase in the proportion of patients with an American Society of Anesthesiologists physical status score ≥3 (P < .001) and a history of heart failure (P = .014). Conversely, there was a decrease in the proportion of patients with hypertension requiring medication and patients who received dialysis (P = .038 and P = .006, respectively). The rate of 30-day medical complications decreased from 8.5% to 4.5% during the study period (P < .001).

Conclusion

Despite increasing medical complexity and increasing diversity of patients undergoing elective TSA during the study period (2012-2020), the rate of 30-day postoperative medical complication rates decreased. These findings demonstrate an improvement in the delivery of care in patients undergoing elective TSA. Reimbursement adjustments should reflect rising patient medical complexity, requiring a reevaluation of frameworks to align with evolving health care models and resource demands.

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来源期刊

Seminars in Arthroplasty Medicine-Surgery

CiteScore

1.00

自引率

0.00%

发文量

104

期刊介绍： Each issue of Seminars in Arthroplasty provides a comprehensive, current overview of a single topic in arthroplasty. The journal addresses orthopedic surgeons, providing authoritative reviews with emphasis on new developments relevant to their practice.