Key result
COPD (OR 2.07), ASA Class IV (OR 5.38), male sex, hypertension, and total operative time were identified as independent risk factors for unplanned 30-day readmission following outpatient rotator cuff repair.
Why the study?
Complications after rotator cuff repair can lead to inpatient readmission, prompting the need to identify demographics and risk factors associated with unplanned 30-day readmissions.
Observational (n=45,548)
Yes
Odds Ratio: 2.07 (95% CI 1.46–2.93)
p-value: p=<0.001
Unplanned 30-day readmission after outpatient rotator cuff repair is rare (1.3%), but risk is increased by male sex, COPD, hypertension, higher ASA class, and longer operative time.
May aid preoperative risk stratification after rotator cuff repair; leaves open whether targeting these factors reduces readmissions.
Introduction Rotator cuff repair (RCR) procedures are some of the most common orthopaedic surgeries performed in the United States. Compared to other orthopaedic procedures, RCRs are of relatively low morbidity. However, complications may arise that result in readmission to an inpatient healthcare facility. The purpose of this study is to identify the demographics and risk factors associated with unplanned 30-day readmission after RCR. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients that underwent elective RCR from 2015-2019. Univariate and multivariate analyses were utilized to assess patient demographics, comorbidities, and peri-operative variables predicting unplanned 30-day readmission. Results Of the identified 45,548 patients that underwent RCR, 597 (1.3%) required readmission within 30 days of the procedure. Multivariate analysis identified male sex (OR 1.36, 95% CI: 1.10, 1.67), hypertension (OR 1.29, 95% CI:1.03, 1.62), chronic obstructive pulmonary disease (COPD) (OR 2.07, 95% CI: 1.46, 2.93), American Society of Anesthesiologists (ASA) Class III (OR 1.85, 95% CI: 1.07, 3.18), ASA Class IV (OR 5.38, 95% CI: 2.70, 10.72), and total operative time (OR 1.002, 95% CI: 1.000, 1.004) as independent risk factors for unplanned readmission. Conclusion Unplanned 30-day readmission after RCR is infrequent. However, certain patients may be at increased risk for unplanned 30-day admission to an inpatient facility. This study confirmed male sex, COPD, hypertension, ASA Class III, ASA Class IV, and total operative time to be independent risk factors for readmission following outpatient RCR.
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Sclafani et al. (2023) conducted an observational in Rotator cuff repair (n=45,548). Patient and perioperative risk factors (e.g., COPD) vs. Patients without respective risk factors was evaluated on Unplanned 30-day readmission (OR 2.07, 95% CI 1.46-2.93, p=<0.001). COPD (OR 2.07), ASA Class IV (OR 5.38), male sex, hypertension, and total operative time were identified as independent risk factors for unplanned 30-day readmission following outpatient rotator cuff repair.
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