TY - JOUR
T1 - Analysis of patient characteristics and outcomes related to distance traveled to a tertiary center for primary reverse shoulder arthroplasty
AU - Dubiel, Matthew J.
AU - Kolz, Joshua M.
AU - Tagliero, Adam J.
AU - Larson, Dirk R.
AU - Maradit Kremers, Hilal
AU - Cofield, Robert R.
AU - Sperling, John W.
AU - Sanchez-Sotelo, Joaquin
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.
PY - 2022/7
Y1 - 2022/7
N2 - Introduction: The reasons for referral and travel patterns are lacking for patients undergoing reverse shoulder arthroplasty (RSA). The purpose of this study was to compare comorbidities, surgical time, cost and complications between local and distant primary RSA patients. Methods: Between 2007 and 2015, 1,666 primary RSAs were performed at our institution. Patients were divided into two cohorts, local patients (from within Olmstead county and surrounding counties, 492 RSAs) and those from a distance (1,174 RSAs). Results: Local patients were older (74 vs 71 years, p <.001), more likely to have RSA for fracture, had a higher Charlson comorbidity score (3.8 vs 3.2, p <.001) and longer hospital stays (2.0 vs 1.8 days, p < 0.001) compared to referred patients. Referral patients required longer operative times (95 vs 88 min, p =.002), had higher hospitalization costs ($19,101 vs $18,735, p <.001), and had a higher rate of prior surgery (32% vs 24%, p <.001). There were no differences between cohorts regarding complications or need for reoperation. Conclusions: Patients traveling from a distance to undergo primary RSA had longer operative times and were more likely to have had prior surgery than local patients. This may demonstrate the referral bias seen at large academic centers and should be considered when reviewing RSA outcomes, hospital performance, and calculating insurance reimbursement. Level of evidence: Level IV.
AB - Introduction: The reasons for referral and travel patterns are lacking for patients undergoing reverse shoulder arthroplasty (RSA). The purpose of this study was to compare comorbidities, surgical time, cost and complications between local and distant primary RSA patients. Methods: Between 2007 and 2015, 1,666 primary RSAs were performed at our institution. Patients were divided into two cohorts, local patients (from within Olmstead county and surrounding counties, 492 RSAs) and those from a distance (1,174 RSAs). Results: Local patients were older (74 vs 71 years, p <.001), more likely to have RSA for fracture, had a higher Charlson comorbidity score (3.8 vs 3.2, p <.001) and longer hospital stays (2.0 vs 1.8 days, p < 0.001) compared to referred patients. Referral patients required longer operative times (95 vs 88 min, p =.002), had higher hospitalization costs ($19,101 vs $18,735, p <.001), and had a higher rate of prior surgery (32% vs 24%, p <.001). There were no differences between cohorts regarding complications or need for reoperation. Conclusions: Patients traveling from a distance to undergo primary RSA had longer operative times and were more likely to have had prior surgery than local patients. This may demonstrate the referral bias seen at large academic centers and should be considered when reviewing RSA outcomes, hospital performance, and calculating insurance reimbursement. Level of evidence: Level IV.
KW - Arthroplasty
KW - Comorbidity
KW - Complications
KW - Cost
KW - Referral
KW - Reoperation
KW - Reverse
KW - Shoulder
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U2 - 10.1007/s00402-021-03764-9
DO - 10.1007/s00402-021-03764-9
M3 - Article
C2 - 33507377
AN - SCOPUS:85099850586
SN - 0936-8051
VL - 142
SP - 1421
EP - 1428
JO - Archives of Orthopaedic and Trauma Surgery
JF - Archives of Orthopaedic and Trauma Surgery
IS - 7
ER -