The influence of gender on early adverse events, hospital charges and length of stay after shoulder arthroplasty

Int Orthop. 2018 Jan;42(1):149-155. doi: 10.1007/s00264-017-3547-6. Epub 2017 Jul 9.

Abstract

Purpose: To identify differences in demographics, diagnosis, arthroplasty type, early adverse events, length of stay, and hospital costs between men and women undergoing shoulder arthroplasty.

Methods: We used a nationally representative U.S. population database to determine annual rates of shoulder arthroplasty (SA) in patients (2002-2011). Early adverse events, length-of-stay and hospitalization costs were determined, and compared between patient genders.

Results: A cohort of 372,753 patients underwent total-SA (TSA) (59.7% females). Females were significantly older, more often had Medicare insurance, had a higher proportion of fracture diagnosis, more often underwent hemiarthroplasty (HA), and had significantly lower odds of any adverse event, MI, and sepsis, but higher odds of peripheral nerve injury. Females had significantly greater hospital lengths of stay for all combined procedures, and isolated TSA, reverse-TSA, and HA. Hospital costs were significantly lower in females for all combined procedures and HA.

Conclusions: Male patients had significantly higher odds of adverse events, death, MI, and sepsis following SA. Female patients had significantly longer lengths of stay but lower hospital charges following SA.

Keywords: Adverse events; Gender; Population study; Shoulder arthroplasty; Trends; Utilization.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Shoulder / adverse effects*
  • Arthroplasty, Replacement, Shoulder / economics
  • Cohort Studies
  • Databases, Factual
  • Female
  • Hospital Charges / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sex Factors*
  • Shoulder Joint / surgery
  • United States
  • Young Adult