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Predicting Discharge Disposition After Shoulder Arthroplasty in the United States

Authors :
Chang-Yeon Kim
Harry A. Hoyen
Joseph E. Tanenbaum
Robert J Gillespie
Glenn D. Wera
Blaine T. Bafus
Nikunj N. Trivedi
Lakshmanan Sivasundaram
Source :
The Journal of the American Academy of Orthopaedic Surgeons. 27(9)
Publication Year :
2018

Abstract

Introduction Postdischarge management for shoulder replacement continues to be performed on a case-by-case basis, with no uniform guidelines dictating management. The goal of this study was to develop a nomogram to preoperatively predict a patient's discharge disposition after elective shoulder arthroplasty. Methods Patients who underwent elective shoulder arthroplasty between 2012 and 2015 were identified in the National Surgical Quality Improvement Program database. A multivariable logistic regression model was used to identify risk factors for discharge to a postacute care facility, and these results were used to create a predictive nomogram. Results From 2012 to 2015, 8,363 procedures were identified. In our cohort, 962 patients (11.5%) were discharged to a postacute care facility, and 7,492 patients (88.5%) were discharged home. Preoperative functional status, followed by American Society of Anesthesiologists Class and age, had the strongest predictive value for discharge disposition after shoulder arthroplasty. Discussion Discharge disposition can be predicted using a nomogram with commonly identified preoperative and intraoperative variables. Level of evidence Level III, retrospective cohort design, observational study.

Details

ISSN :
19405480
Volume :
27
Issue :
9
Database :
OpenAIRE
Journal :
The Journal of the American Academy of Orthopaedic Surgeons
Accession number :
edsair.doi.dedup.....7890c5d4bf8fc4008df019388a56c276