TY - JOUR
T1 - Perioperative Outcomes, Comorbidities, and Complications following Total Shoulder Arthroplasty in Wheelchair Users
T2 - A Retrospective Cohort Analysis of a Nationwide Database
AU - Prabhu, Kevin
AU - Nasr, Andrew J.
AU - Kasitinon, Donald
AU - Cabrera, Alison
AU - Lin, Yen Sheng
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/9
Y1 - 2023/9
N2 - Impaired shoulder function hinders the ability of wheelchair users to maintain independence. The current state of the literature delineates the risks and benefits of surgical techniques for the management of shoulder pathologies. To the best of our knowledge, there is no study that has investigated complications following total shoulder arthroplasty (TSA) in wheelchair users. Utilizing the PearlDiver Mariner national administrative database, 72,108 patients were identified who underwent TSA with a concurrent diagnosis of a rotator cuff tear. Two matched cohorts, one of wheelchair users and one of non-wheelchair users, were created. Due to limitations within PearlDiver, one-year outcomes, including comorbidity and complication rates and readmission statistics, were compared between the two cohorts. Each matched cohort of 869 patients underwent TSA with a concurrent diagnosis of a rotator cuff tear. The rate of readmission in wheelchair users was greater than in non-wheelchair users (24.05% vs. 9.55%, OR: 3.00, CI: 2.279, 3.946). Patients in the wheelchair cohort exhibited higher rates of complications and comorbidities (p < 0.001). Among the most likely to be readmitted after TSA were patients with osteoarthritis, pulmonary heart disease, rheumatoid arthritis, and hypertension (p < 0.05). Significant differences in surgical outcomes existed between wheelchair and non-wheelchair users in terms of preoperative comorbidities, postoperative complications, and readmission rates.
AB - Impaired shoulder function hinders the ability of wheelchair users to maintain independence. The current state of the literature delineates the risks and benefits of surgical techniques for the management of shoulder pathologies. To the best of our knowledge, there is no study that has investigated complications following total shoulder arthroplasty (TSA) in wheelchair users. Utilizing the PearlDiver Mariner national administrative database, 72,108 patients were identified who underwent TSA with a concurrent diagnosis of a rotator cuff tear. Two matched cohorts, one of wheelchair users and one of non-wheelchair users, were created. Due to limitations within PearlDiver, one-year outcomes, including comorbidity and complication rates and readmission statistics, were compared between the two cohorts. Each matched cohort of 869 patients underwent TSA with a concurrent diagnosis of a rotator cuff tear. The rate of readmission in wheelchair users was greater than in non-wheelchair users (24.05% vs. 9.55%, OR: 3.00, CI: 2.279, 3.946). Patients in the wheelchair cohort exhibited higher rates of complications and comorbidities (p < 0.001). Among the most likely to be readmitted after TSA were patients with osteoarthritis, pulmonary heart disease, rheumatoid arthritis, and hypertension (p < 0.05). Significant differences in surgical outcomes existed between wheelchair and non-wheelchair users in terms of preoperative comorbidities, postoperative complications, and readmission rates.
KW - PearlDiver database
KW - complications
KW - revision
KW - total shoulder arthroplasty
KW - wheelchair
UR - http://www.scopus.com/inward/record.url?scp=85172762851&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85172762851&partnerID=8YFLogxK
U2 - 10.3390/jcm12185799
DO - 10.3390/jcm12185799
M3 - Article
C2 - 37762740
AN - SCOPUS:85172762851
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 18
M1 - 5799
ER -