The impact of solid organ transplant history on inpatient complications, mortality, length of stay, and cost for primary total shoulder arthroplasty admissions in the United States

Malcolm, Tennison L.; Chatha, Kiran; Breceda, Adam P.; Guo, Eric W.; Friedman, D. B.; Sabesan, Vani J.; Barsoum, Wael K.

doi:10.1016/j.jse.2018.02.064

Cited by 17 publications

(7 citation statements)

References 16 publications

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“…SOT patients also had longer length of hospital stay. One possible explanation is the higher degree of medical care provided to SOT patients as seen in other non–COVID‐related hospitalizations 22,23 . Another possibility is that the SOT patients in our study had a higher proportion of critical disease and ICU needs (although not found statistically significant).…”

Section: Discussionmentioning

confidence: 56%

A retrospective matched cohort single‐center study evaluating outcomes of COVID‐19 and the impact of immunomodulation on COVID‐19‐related cytokine release syndrome in solid organ transplant recipients

Ringer

Azmy

Kaman

et al. 2021

Transplant Infectious Dis

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This retrospective matched cohort study describes 30 solid organ transplant (SOT) patients with Coronavirus Disease 2019 (COVID‐19) matched 1:2 to 60 non‐SOT patients (control group) based on age, body mass index (BMI), and comorbidities (hypertension and diabetes mellitus with hemoglobin A1c > 8.0%). The SOT group had a higher proportion of cardiovascular disease ( P < .05). During the index hospitalization, there were no significant differences with regard to disease severity or critical care needs (mechanical intubation, vasopressors, and renal replacement therapy). At 28 days, 4 (13%) patients died in the SOT group and 8 (13%) patients died in the control group ( P = 1.0). Nineteen patients received tocilizumab in the SOT group compared to 29 patients in the control group. Among these patients, interleukin‐6 (IL‐6) and soluble interleukin‐2 receptor (sIL2R) levels increased after tocilizumab and interleukin‐10 (IL‐10) levels decreased after tocilizumab. Overall, SOT patients had comparable mortality to non‐SOT patients, although numerically more SOT patients received tocilizumab (63% vs 48%) and steroids (37% vs 20%). Larger, multi‐center studies are needed to ascertain these findings. Lastly, the complex cytokine release syndrome in COVID‐19 remains an area of intense research and the analysis of key interleukin levels (IL‐6, IL‐10, and sIL2R) in this study contributes to the understanding of this process.

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Section: Discussionmentioning

confidence: 56%

A retrospective matched cohort single‐center study evaluating outcomes of COVID‐19 and the impact of immunomodulation on COVID‐19‐related cytokine release syndrome in solid organ transplant recipients

Ringer

Azmy

Kaman

et al. 2021

Transplant Infectious Dis

View full text Add to dashboard Cite

show abstract

“…Complication rates were calculated using ICD-9 and ICD-10 codes for post-operative complications identified in previous similar orthopedic studies using HCUP data. 28 , 31 Complications included in the 90-day post-operative period included both mechanical complications (including hardware failure, dislocation, loosening, periprosthetic osteolysis, and periprosthetic fracture) and medical complications (including bleeding, cardiac-related, central nervous system-related, gastro-intestinal-related, acute renal failure, urinary tract infection, post-operative infection, peripheral vascular-related, shock, respiratory-related, wound-related, cellulitis, pulmonary embolism, pneumonia, acute respiratory distress syndrome, sepsis, thrombosis, transfusion necessary, and debridement necessary). All patients who received an additional procedure within the 90-day window were excluded to ensure that the complication was related to the TEA.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…21,23 Several patient comorbidities that are potentially predictive of inferior outcomes have also been identified for TSA, including depression, obesity, chronic lung disease, chronic renal disease, heart disease, paraplegia, and history of a previous solid organ transplant. 22,[24][25][26][27][28] Therefore, the purpose of this study is to determine what patient demographic factors, hospital characteristics, and medical comorbidities affect 90-day complication and revision rates following TEA. Current literature is limited to 30-day complication and revision rates, only accounting for events that occurred within the first 30 days after surgery.…”

Section: Introductionmentioning

confidence: 99%

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Identification of Independent Predictors of Increased 90-Day Complication and Revision Rates Following Total Elbow Arthroplasty

Kunkle

Baxter

Welsh

et al. 2023

Journal of Shoulder and Elbow Arthroplasty

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Introduction Total elbow arthroplasty (TEA) is an increasingly popular surgical option for many debilitating conditions of the elbow. There currently exists a paucity of literature regarding patient and hospital factors that lead to inferior outcomes following TEA. The purpose of this study is to identify independent predictors of increased complication and revision rates following TEA. Methods The National Readmissions Database (NRD) was queried from 2011 to 2018 to identify all cases of TEA (n = 8932). Relevant patient demographic factors, comorbidities, and hospital characteristics were identified and run in a univariate binomial logistic regression model. All significant variables were included in a multivariate binomial logistic regression model for data analysis. Results Independent predictors of increased complication rates included age, female sex, Medicare and Medicaid payer status, medium bed-sized center, and 18 of 34 medical comorbidities (all P < .05). Independent predictors of increased revision rates included medium bed-sized centers, non-teaching hospital status, chronic pulmonary disease, depression, and pulmonary circulatory disorders (all P < .05). Conclusion This study identified several patient and hospital characteristics that are independently associated with both increased complication and revision rates following TEA. This information can aid orthopedic surgeons during shared decision making when considering TEA in patients. Level of Evidence Level III, retrospective cohort study.

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“…Therefore, with the purpose of optimizing postoperative outcomes and reducing the requirement for revision procedures after TSA, it is imperative to determine preoperatively whether patients are at high risk of early PRCs. Numerous risk factors for the above complications have been reported by prior studies [7,[9][10][11][12][13][14][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors of In-hospital Prosthesis-Related Complications Following Total Shoulder Arthroplasty

Yang

Xie

Liu

et al. 2021

Preprint

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BackgroundThe occurrence of prosthesis-related complications after total shoulder arthroplasty is devastating and costly. The purpose was to determine the incidence and risk of in-hospital prosthesis-related complications after total shoulder arthroplasty utilizing a large-scale sample database.MethodsA retrospective database analysis was performed based on Nationwide Inpatient Sample from 2010 to 2014. Patients who underwent total shoulder arthroplasty were included. Patient demographics, hospital characteristics, length of stay, economic indicators, in-hospital mortality, comorbidities, and peri-operative complications were evaluated.ResultsA total of 34,198 cases were capture from the Nationwide Inpatient Sample database. There were 343 cases of in-hospital prosthesis-related complications after total shoulder arthroplasty and the overall incidence was 1%, with a more than 2.5-fold decrease from 2010 to 2014. Dislocation was the most common category among prosthesis-related complications (0.1%). The occurrence of in-hospital prosthesis-related complications was associated with significantly more total charges and slightly longer length of stay while less usage of Medicare. Risk factors of prosthesis-related complications were identified including younger age (<64 years), female, the native American, hospital in the South, alcohol abuse, depression, uncomplicated diabetes, diabetes with chronic complications, fluid and electrolyte disorders, metastatic cancer, neurological disorders, and renal failure. Interestingly, advanced age (≥65 years) and proprietary hospital were found as protective factors. Furthermore, prosthesis-related complications were associated with aseptic necrosis, rheumatoid arthritis, rotator cuff tear arthropathy, Parkinson’s disease, prior shoulder arthroscopy, and blood transfusion.ConclusionsIt is of benefit to study risk factors of prosthesis-related complications following total shoulder arthroplasty to ensure the appropriate management and optimize consequences although a relatively low incidence was identified.

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The impact of solid organ transplant history on inpatient complications, mortality, length of stay, and cost for primary total shoulder arthroplasty admissions in the United States

Cited by 17 publications

References 16 publications

A retrospective matched cohort single‐center study evaluating outcomes of COVID‐19 and the impact of immunomodulation on COVID‐19‐related cytokine release syndrome in solid organ transplant recipients

A retrospective matched cohort single‐center study evaluating outcomes of COVID‐19 and the impact of immunomodulation on COVID‐19‐related cytokine release syndrome in solid organ transplant recipients

Identification of Independent Predictors of Increased 90-Day Complication and Revision Rates Following Total Elbow Arthroplasty

Incidence and Risk Factors of In-hospital Prosthesis-Related Complications Following Total Shoulder Arthroplasty

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