March 17, 2016
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Several patient risk factors associated with discharge to post-acute care after TSA

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Results of this study cited several patient risk factors, including older age, number of comorbidities and procedure type, linked with an increased risk of discharge to a post-acute care facility after total shoulder arthroplasty.

Researchers analyzed the Nationwide Inpatient Sample discharge records from 2011 to 2012 for patients who underwent either total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA). Using univariate and multivariate analyses, researchers determined the statistically significant risk factors for discharge to a post-acute care facility.

Overall, 103,798 patients underwent shoulder arthroplasty procedures. Of these, 58,937 were TSAs and 44,893 were RTSAs.

Results showed patients older than 85 years were 17-times more likely to be discharged to a post-acute care facility vs. patients younger than 65 years. Patients who underwent RTSA were 1.3-times as likely to be discharged to a post-acute care facility than patients who underwent TSA. Compared with men, women were 2.8-times as likely to be discharged to a post-acute care facility.

Researchers noted each additional comorbidity increased the likelihood of discharge to a post-acute care facility by 13%, with patients with congestive heart failure being twice as likely and patients with diabetes being 1.5-times as likely to be discharged to a post-acute care facility. Patients who had a shoulder arthroplasty for fracture were twice as likely to be discharged to a post-acute care facility. However, regardless of the indication, patients who had a revision shoulder arthroplasty were less likely to be discharged to a post-acute care facility.

According to results, for each additional inpatient day, patients were 3.3-times as likely to be discharged to a post-acute care facility. Medicare patients were twice as likely to be discharged to a post-acute care facility as patients with private insurance. When it came to location, patients in the South were 3.7-times as likely to be discharged to a post-acute care facility as patients who underwent shoulder arthroplasty in the West, and patients in the Northeast and Midwest also were more likely to be discharged to a post-acute care facility after shoulder arthroplasty. – by Casey Tingle

 

Disclosure: The researchers report no relevant financial disclosures.