Source:

Garrigues GE. Outpatient shoulder arthroplasty: Appropriate patient selection. Presented at: American Shoulder and Elbow Surgeons Specialty Day Meeting; Feb. 27, 2021 (virtual meeting).

Disclosures: Garrigues reports he is a paid consultant for Additive Orthopaedics, DJ Orthopaedics, Mitek and Tornier; is a board or committee member for the American Shoulder and Elbow Surgeons and Arthroscopy Association of North America; receives other financial or material support from Arthrex Inc., DJ Orthopaedics and SouthTech; has stock or stock options in CultivateMD, Genesys, Patient IQ and ROM 3; receives IP royalties from and is a paid presenter or speaker for DJ Orthopaedics and Tornier; and is on the editorial or governing board for the Journal of Shoulder and Elbow Surgery and Techniques in Orthopaedics.
March 03, 2021
1 min read
Save

Outpatient shoulder arthroplasty may be safe for Medicare patients

Source:

Garrigues GE. Outpatient shoulder arthroplasty: Appropriate patient selection. Presented at: American Shoulder and Elbow Surgeons Specialty Day Meeting; Feb. 27, 2021 (virtual meeting).

Disclosures: Garrigues reports he is a paid consultant for Additive Orthopaedics, DJ Orthopaedics, Mitek and Tornier; is a board or committee member for the American Shoulder and Elbow Surgeons and Arthroscopy Association of North America; receives other financial or material support from Arthrex Inc., DJ Orthopaedics and SouthTech; has stock or stock options in CultivateMD, Genesys, Patient IQ and ROM 3; receives IP royalties from and is a paid presenter or speaker for DJ Orthopaedics and Tornier; and is on the editorial or governing board for the Journal of Shoulder and Elbow Surgery and Techniques in Orthopaedics.
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Medicare patients may be able to safely undergo outpatient shoulder arthroplasty despite a more severe comorbidity burden, according to results presented at the American Shoulder and Elbow Surgeons Specialty Day Meeting.

Using the Duke-Rush Shoulder Consortium database, Grant E. Garrigues, MD, and colleagues reviewed data on Medicare patients with a short hospital stay after shoulder arthroplasty as a proxy for patients who may be appropriate for outpatient shoulder arthroplasty. Researchers reviewed whether Medicare patients were safe to discharge the same day as surgery, which patients were at higher risk for 90-day readmission and which patients were at higher risk of requiring a skilled nursing facility.

Garrigues noted 13 variables predicted the likelihood that patients could have a same-day discharge, including duration of surgery, age, gender and marital status. He added 11 preoperative variables predicted patients at risk for skilled nursing facility admission, as well as 16 preoperative variables that predicted the likelihood that a patient would have a higher readmission rate after same-day discharge.

Grant E. Garrigues
Grant E. Garrigues

Compared with non-Medicare patients, Garrigues noted Medicare patients who had a short stay after surgery did not have a statistically increased risk of 90-day readmission. However, Medicare patients who had a longer hospital stay trended toward statistical significance for higher readmission rate due to a higher percentage of reverse shoulder arthroplasties performed, according to Garrigues.

“If you look by reverse and anatomic and stratify that, the difference completely goes away,” Garrigues said in his presentation. “So, it is based on ... the higher 90-day readmission rate of the reverse total shoulder arthroplasty and the fact that Medicare patients tend to get that procedure at a higher rate.”