Complications and readmissions following reverse total shoulder arthroplasty with same-day discharge

Abstract

Background: Recent studies have demonstrated the safety of anatomic total shoulder arthroplasty (TSA) in an outpatient setting. No clinical studies to date have specifically analyzed complication and readmission rates following RTSA with same-day discharge. The purpose of this study was to compare the 90-day complication and readmission rates of patients undergoing reverse total shoulder arthroplasty (RTSA) who were discharged to home on the same day with those of patients who were admitted to the inpatient setting for at least one night.Methods: 135 consecutive patients who underwent 144 RTSA between were analyzed. Suitability for same-day discharge was determined preoperatively using standardized criteria. Operative time, 90-day readmission and complication rates, as well as ASA class and Charlson Comorbidity Index scores were recorded and compared between groups. Differences between the patients undergoing inpatient RTSA (Group 1) versus RTSA with same-day discharge (Group 2) were evaluated with student's t-test, Mann–Whitney, or Chi square as statistically appropriate, and reported as p-values.Results: Group 1 was significantly older than Group 2 when analyzed as a whole (74.3 years vs. 67.5 years, p < 0.001) and when stratified by ASA score. Group 1 had significantly higher ASA and CCI scores than Group 2 (p < 0.001). Average total operating room (OR) time was significantly longer in Group 1 than Group 2 (183 ± 45 min versus 153 ± 30 min, respectively; p < 0.001). There were 7 postoperative complications (7.6%) in Group 1 (2 postoperative seromas, 1 stress fracture, 1 dissociation of prosthesis, 1 brachial plexopathy, 1 episode of syncope, and 1 C acnes reinfection) within the 90-day postoperative period. There were 4 postoperative complications (7.7%) in Group 2 (2 postoperative seromas, 1 periprosthetic fracture, and 1 dislocation). One patient (1.1%) in Group 1 (C. Acnes infection) and 1 patient (1.9%) in Group 2 (periprosthetic fracture) required readmission within 90 days. There were no significant differences in postoperative complications or readmissions between the groups.Conclusion: RTSA with same-day discharge is a safe option for appropriately selected patients. Same-day discharge does not increase 90-day readmission and complication rates following RTSA.Level of Evidence: Level III