Does age at surgery influence short-term outcomes and readmissions following anatomic total shoulder arthroplasty?

The geriatric nutritional risk index as a strong predictor of adverse outcomes following total shoulder arthroplasty

“… 32 , 37 In the setting of TSA, advanced age, health comorbidities such as obesity, cardiac disease, and immunosuppression, and preoperative laboratory abnormalities such as hypoalbuminemia, anemia, thrombocytopenia, and thrombocytosis are factors associated with poorer outcomes postoperatively. 6 , 7 , 9 , 11 , 22 , 24 , 25 , 29 , 40 In this study, we investigated patients’ degree of malnutrition based on GNRI as a risk factor for postoperative complications in geriatric patients undergoing TSA. We found that several complications associated with malnutrition were moderate to life-threatening postoperative complications, including sepsis, pneumonia, unplanned reintubation, UTI, cardiac arrest or MI, stroke, blood transfusions, failure to wean off a ventilator within 48 hours, C. diff infection, nonhome discharge, readmission, unplanned reoperation, LOS > 2 days, and mortality.…”

“…Although postoperative complications remain relatively uncommon, they occur at a considerably higher rate in older patients and those with chronic health comorbidities such as obesity, cardiac disease, and immunosuppression. 9 , 25 , 29 , 40 In addition to factors related to patient history, preoperative laboratory abnormalities such as hypoalbuminemia, anemia, thrombocytopenia, and thrombocytosis have been identified as factors associated with poorer outcomes following TSA. 6 , 7 , 11 , 22 , 24 In particular, malnutrition in the elderly has been recognized as an important predictor of increased length of stay (LOS) in the hospital and postoperative morbidity in both emergency and elective surgical procedures.…”

A comprehensive analysis of age and 30-day complications following total shoulder arthroplasty: nonagenarians, octogenarians, and septuagenarians

“… 4 , 6 On the other hand, when compared to younger cohorts, older patients have been reported to be at decreased risk for dislocation, perioperative fracture, implant related complications, and surgical site infections. 35 , 38 …”

“…Consistent with our results, other studies have reported increased age as an independent risk factor for readmission following TSA, with medical causes accounting for up to 50% of readmissions. 24 , 37 , 38 A study on primary TSA found that old age leads to higher rates of readmission, most commonly due to pneumonia, dislocation, pulmonary embolism, and surgical site infections. 8 Similarly, a study by White et al found older age was more likely to be associated with readmission, as well as multiple medical complications such as pulmonary embolism, infection, and respiratory complications.…”

“… 8 Similarly, a study by White et al found older age was more likely to be associated with readmission, as well as multiple medical complications such as pulmonary embolism, infection, and respiratory complications. 38 …”