Survivorship after reverse total shoulder arthroplasty and predictors of 1-year and overall mortality

Abdelmalik, Bishoy; Hao, Kevin A.; Turnbull, Lacie M; Wright, Thomas W.; Wright, Jonathan O.; Farmer, Kevin W.; Pazik, Marissa; King, Joseph J.

doi:10.1016/j.jse.2022.06.030

Journal of Shoulder and Elbow Surgery

2023

DOI: 10.1016/j.jse.2022.06.030

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Survivorship after reverse total shoulder arthroplasty and predictors of 1-year and overall mortality

Bishoy Abdelmalik

Kevin A. Hao

Lacie M Turnbull

et al.

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Cited by 3 publications

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“…Previous studies have reported complication rates following shoulder arthroplasty 4 , 5 ; however, information is limited regarding long-term survival and patient outcomes 6 , 7 . Furthermore, the long-term value to the patient following shoulder arthroplasty is poorly defined.…”

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confidence: 99%

“…Prior studies have evaluated in-hospital, 30-day, 90-day, and 1-year mortality following shoulder replacement 7,10,[16][17][18] , but no prior work, to our knowledge, has quantified mid-and long-term mortality. The purposes of the present study were to evaluate 5year patient mortality following shoulder arthroplasty in patients ‡65 years old and to stratify this population into fracture and nonfracture groups.…”

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Five-Year Mortality Rates Following Elective Shoulder Arthroplasty and Shoulder Arthroplasty for Fracture in Patients Over Age 65

Khan,

Zhang,

Macarayan

et al. 2024

JBJS Open Access

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Background: To effectively counsel patients prior to shoulder arthroplasty, surgeons should understand the overall life trajectory and life expectancy of patients in the context of the patient’s shoulder pathology and medical comorbidities. Such an understanding can influence both operative and nonoperative decision-making and implant choices. This study evaluated 5-year mortality following shoulder arthroplasty in patients ≥65 years old and identified associated risk factors. Methods: We utilized Centers for Medicare & Medicaid Services Fee-for-Service inpatient and outpatient claims data to investigate the 5-year mortality rate following shoulder arthroplasty procedures performed from 2014 to 2016. The impact of patient demographics, including fracture diagnosis, year fixed effects, and state fixed effects; patient comorbidities; and hospital-level characteristics on 5-year mortality rates were assessed with use of a Cox proportional hazards regression model. A p value of <0.05 was considered significant. Results: A total of 108,667 shoulder arthroplasty cases (96,104 nonfracture and 12,563 fracture) were examined. The cohort was 62.7% female and 5.8% non-White and had a mean age at surgery of 74.3 years. The mean 5-year mortality rate was 16.6% across all shoulder arthroplasty cases, 14.9% for nonfracture cases, and 29.9% for fracture cases. The trend toward higher mortality in the fracture group compared with the nonfracture group was sustained throughout the 5-year postoperative period, with a fracture diagnosis being associated with a hazard ratio of 1.63 for mortality (p < 0.001). Medical comorbidities were associated with an increased risk of mortality, with liver disease bearing the highest hazard ratio (3.07; p < 0.001), followed by chronic kidney disease (2.59; p < 0.001), chronic obstructive pulmonary disease (1.92; p < 0.001), and congestive heart failure (1.90; p < 0.001). Conclusions: The mean 5-year mortality following shoulder arthroplasty was 16.6%. Patients with a fracture diagnosis had a significantly higher 5-year mortality risk (29.9%) than those with a nonfracture diagnosis (14.9%). Medical comorbidities had the greatest impact on mortality risk, with chronic liver and kidney disease being the most noteworthy. This novel longer-term data can help with patient education and risk stratification prior to undergoing shoulder replacement. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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confidence: 99%

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confidence: 99%

Five-Year Mortality Rates Following Elective Shoulder Arthroplasty and Shoulder Arthroplasty for Fracture in Patients Over Age 65

Khan,

Zhang,

Macarayan

et al. 2024

JBJS Open Access

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Shoulder periprosthetic joint infection is associated with increased mortality

Chen

Vaughan

Cox

et al. 2023

Journal of Shoulder and Elbow Surgery

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Patients with chronic kidney disease can expect significant improvement in pain and function after shoulder arthroplasty

Burns,

Robbins,

LeMarr

et al. 2024

Seminars in Arthroplasty: JSES

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Survivorship after reverse total shoulder arthroplasty and predictors of 1-year and overall mortality

Cited by 3 publications

References 33 publications

Five-Year Mortality Rates Following Elective Shoulder Arthroplasty and Shoulder Arthroplasty for Fracture in Patients Over Age 65

Five-Year Mortality Rates Following Elective Shoulder Arthroplasty and Shoulder Arthroplasty for Fracture in Patients Over Age 65

Shoulder periprosthetic joint infection is associated with increased mortality

Patients with chronic kidney disease can expect significant improvement in pain and function after shoulder arthroplasty

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