Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement Program
Background Total elbow arthroplasty (TEA) is uncommon, but growing in incidence. Traditionally an inpatient operation, a growing number are performed outpatient, consistent with general trends in orthopedic surgery. The aim of this study was to compare TEA outcomes between inpatient and outpatient s...
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| Format: | Article |
| Language: | English |
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Korean Shoulder and Elbow Society
2023-12-01
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| Series: | Clinics in Shoulder and Elbow |
| Subjects: | |
| Online Access: | http://www.cisejournal.org/upload/pdf/cise-2023-00486.pdf |
| _version_ | 1797306974400937984 |
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| author | David Momtaz Farhan Ahmad Aaron Singh Emilie Song Dean Slocum Abdullah Ghali Adham Abdelfattah |
| author_facet | David Momtaz Farhan Ahmad Aaron Singh Emilie Song Dean Slocum Abdullah Ghali Adham Abdelfattah |
| author_sort | David Momtaz |
| collection | DOAJ |
| description | Background Total elbow arthroplasty (TEA) is uncommon, but growing in incidence. Traditionally an inpatient operation, a growing number are performed outpatient, consistent with general trends in orthopedic surgery. The aim of this study was to compare TEA outcomes between inpatient and outpatient surgical settings. Secondarily, we sought to identify patient characteristics that predict the operative setting. Methods Patient data were collected from the American College of Surgeons National Quality Improvement Program. Preoperative variables, including patient demographics and comorbidities, were recorded, and baseline differences were assessed via multivariate regression to predict operative setting. Multivariate regression was also used to compare postoperative complications within 30 days. Results A total of 468 patients, 303 inpatient and 165 outpatient procedures, were identified for inclusion. Hypoalbuminemia (odds ratio [OR], 2.5; P=0.029), history of chronic obstructive pulmonary disorder or pneumonia (OR, 2.4; P=0.029), and diabetes mellitus (OR, 2.5; P=0.001) were significantly associated with inpatient TEA, as were greater odds of any complication (OR, 4.1; P<0.001) or adverse discharge (OR, 4.5; P<0.001) and decreased odds of reoperation (OR, 0.4; P=0.037). Conclusions Patients undergoing inpatient TEA are generally more comorbid, and inpatient surgery is associated with greater odds of complications and adverse discharge. However, we found higher rates of reoperation in outpatient TEA. Our findings suggest outpatient TEA is safe, although patients with a higher comorbidity burden may require inpatient surgery. Level of evidence III |
| first_indexed | 2024-03-08T00:50:37Z |
| format | Article |
| id | doaj.art-11bedf9eb39c4a97957c0e75ad11e9c5 |
| institution | Directory Open Access Journal |
| issn | 2288-8721 |
| language | English |
| last_indexed | 2024-03-08T00:50:37Z |
| publishDate | 2023-12-01 |
| publisher | Korean Shoulder and Elbow Society |
| record_format | Article |
| series | Clinics in Shoulder and Elbow |
| spelling | doaj.art-11bedf9eb39c4a97957c0e75ad11e9c52024-02-15T04:40:54ZengKorean Shoulder and Elbow SocietyClinics in Shoulder and Elbow2288-87212023-12-0126435135610.5397/cise.2023.00486954Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement ProgramDavid Momtaz0Farhan Ahmad1Aaron Singh2Emilie Song3Dean Slocum4Abdullah Ghali5Adham Abdelfattah6 Department of Orthopaedics, UT Health San Antonio, San Antonio, TX, USA Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA Department of Orthopaedics, UT Health San Antonio, San Antonio, TX, USA Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA Department of Orthopaedics, UT Health San Antonio, San Antonio, TX, USA Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA Institute of Orthopaedic Special Surgery, San Antonio, TX, USABackground Total elbow arthroplasty (TEA) is uncommon, but growing in incidence. Traditionally an inpatient operation, a growing number are performed outpatient, consistent with general trends in orthopedic surgery. The aim of this study was to compare TEA outcomes between inpatient and outpatient surgical settings. Secondarily, we sought to identify patient characteristics that predict the operative setting. Methods Patient data were collected from the American College of Surgeons National Quality Improvement Program. Preoperative variables, including patient demographics and comorbidities, were recorded, and baseline differences were assessed via multivariate regression to predict operative setting. Multivariate regression was also used to compare postoperative complications within 30 days. Results A total of 468 patients, 303 inpatient and 165 outpatient procedures, were identified for inclusion. Hypoalbuminemia (odds ratio [OR], 2.5; P=0.029), history of chronic obstructive pulmonary disorder or pneumonia (OR, 2.4; P=0.029), and diabetes mellitus (OR, 2.5; P=0.001) were significantly associated with inpatient TEA, as were greater odds of any complication (OR, 4.1; P<0.001) or adverse discharge (OR, 4.5; P<0.001) and decreased odds of reoperation (OR, 0.4; P=0.037). Conclusions Patients undergoing inpatient TEA are generally more comorbid, and inpatient surgery is associated with greater odds of complications and adverse discharge. However, we found higher rates of reoperation in outpatient TEA. Our findings suggest outpatient TEA is safe, although patients with a higher comorbidity burden may require inpatient surgery. Level of evidence IIIhttp://www.cisejournal.org/upload/pdf/cise-2023-00486.pdfinpatientsoutpatientselbowsurgeryupper extremityarthroplasty |
| spellingShingle | David Momtaz Farhan Ahmad Aaron Singh Emilie Song Dean Slocum Abdullah Ghali Adham Abdelfattah Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement Program Clinics in Shoulder and Elbow inpatients outpatients elbow surgery upper extremity arthroplasty |
| title | Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement Program |
| title_full | Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement Program |
| title_fullStr | Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement Program |
| title_full_unstemmed | Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement Program |
| title_short | Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement Program |
| title_sort | inpatient or outpatient total elbow arthroplasty a comparison of patient populations and 30 day surgical outcomes from the american college of surgeons national surgical quality improvement program |
| topic | inpatients outpatients elbow surgery upper extremity arthroplasty |
| url | http://www.cisejournal.org/upload/pdf/cise-2023-00486.pdf |
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