September 01, 2019
1 min read

Frailty may increase complications after total shoulder arthroplasty

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Russell E. Holzgrefe

Frail patients may experience an increased risk of early complications and adverse outcomes after total shoulder arthroplasty, according to results.

Russell E. Holzgrefe , MD, and colleagues used Pearson analysis and linear regression to determine the association of the modified frailty index score with 30-day postoperative complications, reoperation, readmission, length of stay, adverse hospital discharge and mortality rate among 9,861 patients aged 50 years or older who underwent total shoulder arthroplasty (TSA).

Researchers found an increase in postoperative complications (4.2% to 9.4%), readmission (1.6% to 4.4%), adverse hospital discharge (6.3% to 19.6%) and length of stay (1.88 days to 2.43 days) as the modified frailty index score increased from 0 to 2 or more. Postoperative complications, readmissions, reoperations and adverse hospital discharge were more than twice as likely to occur among patients with a modified frailty index score of 2 or more, according to multivariate analysis. Compared with age, results showed these effects were all significantly higher.

“Our study demonstrates that increasing frailty is predictive of increased 30-day postoperative complications following total shoulder arthroplasty,” Holzgrefe told “A simple frailty assessment using the five-item modified frailty index allows physicians to account for the heterogeneity of the elderly population’s physiologic reserve rather than relying on age alone as a surrogate. This has potential implications in providing individualized patient counseling and risk assessment, preoperative planning and medical optimization, and in risk stratification for emerging payment models.” – by Casey Tingle


Disclosure: Holzgrefe reports no relevant financial disclosures.