Sex differences in complications and readmission rates following shoulder arthroplasty in the United States

Knapp, Brock; Botros, Mina; Sing, David C.; Curry, Emily J.; Eichinger, Josef K.; Li, Xinning

doi:10.1016/j.jseint.2019.11.007

Cited by 11 publications

(3 citation statements)

References 30 publications

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“…The greater rate of minor adverse effects among females is evidently driven by an increased incidence of urinary tract infection, and this difference is likely a consequence of anatomic and hormonal contributions that naturally place females at greater risk rather than secondary to surgical intervention. The finding that males experience a higher rate of severe adverse events is in accordance with previous literature demonstrating similarly increased risk of death, myocardial infarction, and sepsis following orthopedic procedures including total shoulder arthroplasty, 25 , 42 lower extremity arthroplasty, 35 , 44 and spine surgery. 4 , 34 There are a number of possible explanations for these results.…”

Section: Discussionsupporting

confidence: 91%

Sex differences in utilization and perioperative outcomes of arthroscopic rotator cuff repair

et al. 2022

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Section: Discussionsupporting

confidence: 91%

Sex differences in utilization and perioperative outcomes of arthroscopic rotator cuff repair

et al. 2022

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“…There have been mixed findings depending on disease state; men had increased rates of surgical site infections after shoulder arthroplasty, although there was no difference in complication rates. 23 Among cardiac surgery patients, female sex predicted in-hospital mortality after coronary artery bypass grafting. 24 A study of patients undergoing intra-abdominal surgeries found a lower risk of 30-day mortality, readmission, and major complications among women on unadjusted analysis, although this difference was not significant after adjusting for other patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

Sex-Based Differences in IBD Surgical Outcomes

Sundel,

Newland,

Blackburn

et al. 2023

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Although there are discrepancies in the development and progression of inflammatory bowel disease based on biologic sex, little is known about differences in postoperative outcomes between men and women undergoing surgery for this condition. OBJECTIVE: Our objective was to compare rates of anastomotic leaks, wound complications, and serious adverse events between men and women undergoing surgery for inflammatory bowel disease. DESIGN: This was a retrospective cohort study. SETTINGS: Data were obtained from the American College of Surgeons National Surgical Quality Improvement Program Inflammatory Bowel Disease Collaborative database, which includes 15 high-volume inflammatory bowel disease surgery centers. PATIENTS: All adult patients undergoing surgery for inflammatory bowel disease were included. Subjects with missing data for exposure or outcome variables were excluded. MAIN OUTCOME MEASURES: Rates of anastomotic leaks, wound complications, and serious adverse events were compared between women and men. RESULTS: A total of 3143 patients were included. There was a significant association between sex and body mass index, inflammatory bowel disease type, and preoperative medication use. Women had decreased odds of serious adverse events compared to men (OR=0.73, 95% CI: 0.55-0.96), but there was no significant association between sex and anastomotic leaks or wound complications. Inflammatory bowel disease type was found to be an effect measure modifier of the relationship between sex and serious adverse events. Among ulcerative colitis patients, women had a 54% decrease in the odds of serious adverse events compared to men, while there was no significant difference between women and men with Crohn’s disease. LIMITATIONS: This study was limited by capturing only 30 days of postoperative outcomes. CONCLUSIONS: Women undergoing surgery for ulcerative colitis had decreased odds of serious adverse events compared to men. Understanding sex-based differences in outcomes allows clinicians to make patient-centered decisions regarding surgical planning and perioperative management for inflammatory bowel disease patients..

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“…Furthermore, Brock et al analyzed a cohort of 5499 female and 6949 male patients receiving RTSA without specification of the reason for surgery. They concluded that men have a decreased risk of urinary tract infection, blood transfusion, prolonged length of hospital stay and an increased risk for surgical site infection and prolonged operating time [ 53 ]. To summarize, the results of the present study fill the knowledge gap regarding male risk profiles after RTSA, emphasizing male sex as an independent risk factor for MAEs and surgical complications after RTSA.…”

Section: Discussionmentioning

confidence: 99%

Male Sex Is Associated with Higher Mortality and Increased Risk for Complications after Surgical Treatment of Proximal Humeral Fractures

Köppe

Katthagen

Rischen

et al. 2021

JCM

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Aims: The best surgical treatment of multi-fragmentary proximal humeral fractures in the elderly is a highly controversial topic. The aim of this study is to assess for sex-related differences regarding mortality and complications after reverse total shoulder arthroplasty (RTSA) and locking plate fixation (LPF). Patients and Methods: All patients from the largest German healthcare insurance (26.5 million policy holders) above the age of 65 years that were treated with LPF or RTSA after a multi-fragmentary proximal humerus fracture between January 2010 and September 2018 were included. Multivariable Cox regression models were used to assess the association of sex with overall survival, major adverse events and surgical complications. Results: A total of 8264 (15%) men and 45,707 (85%) women were followed up for a median time of 52 months. After 8 years, male patients showed significantly higher rates for death (65.8%; 95% CI 63.9–67.5% vs. 51.1%; 95% CI 50.3–51.9%; p < 0.001) and major adverse events (75.5%; 95% CI 73.8–77.1% vs. 61.7%; 95% CI 60.9–62.5%; p < 0.001). With regard to surgical complications, after adjustment of patient risk profiles, there were no differences between females and males after LPF (p > 0.05), whereas men showed a significantly increased risk after RTSA (HR 1.86; 95% CI 1.56–2.22; p < 0.001) with more revision surgeries performed (HR 1.76, 95% CI 1.46–2.12; p < 0.001) compared to women. Conclusion: The male sex is an independent risk factor for death and major adverse events after both LPF and RTSA. An increased risk for surgical complications after RTSA suggests that male patients benefit more from LPF. Sex should be considered before making treatment decisions.

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Sex differences in complications and readmission rates following shoulder arthroplasty in the United States

Cited by 11 publications

References 30 publications

Sex differences in utilization and perioperative outcomes of arthroscopic rotator cuff repair

Sex differences in utilization and perioperative outcomes of arthroscopic rotator cuff repair

Sex-Based Differences in IBD Surgical Outcomes

Male Sex Is Associated with Higher Mortality and Increased Risk for Complications after Surgical Treatment of Proximal Humeral Fractures

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