۹۰-day Return to the Emergency Department Following Shoulder Arthroscopy: Prevalence, Risk Factors, and Reasons

Objectives: Return to the Emergency Department (ED) within ۹۰-days following arthroscopic shoulder surgery represents a potential source of increased healthcare expenditures. Understanding the risk factors could bring about interventions aimed at reducing its prevalence. Methods: A retrospective review of all shoulder arthroscopies undertaken at a single academic institution from February ۲۰۱۶ through November ۲۰۲۳ was performed. Patient demographics and surgical data, including age, diagnosis of mental health disorder, history of prior ipsi- and/or contralateral shoulder arthroscopy, body mass index (BMI), smoking status, age-adjusted Charlson Comorbidity Index (ACCI), operative time and nature of the surgical procedure was collected. Patient visits to the ED within ۱۲ months prior to surgery were recorded. Regression analysis was utilized to determine the independent predictors for ۹۰-day postoperative ED return. Results: There were ۵۸۴ total cases included in this study, of which ۳۰۳ (۵۲%) were women. The median age of the cohort was ۵۷ years (IQR ۵۱,۶۲). There were ۶۰ (۱۰.۳%) patients who experienced at least one unplanned ۹۰-day ED return visit. A diagnosis of mental health disorder (OR ۲.۶۷, ۹۵% CI ۱.۵۰-۴.۷۵, P=۰.۰۰۱), an ED visit within ۳ months of surgery (OR ۲.۶۳, ۹۵% CI ۱.۲۸-۵.۴۰, P=۰.۰۰۹), an ED visit between ۳-۶ months of surgery (OR ۲.۷۹, ۹۵% CI ۱.۴۱-۵.۵۴, P=۰.۰۰۳), and an ED visit between ۶-۱۲ months of surgery (OR ۱.۹۸, ۹۵% CI ۱.۰۷-۳.۶۶, P=۰.۰۲۹) was significantly associated with a ۹۰-day unplanned postoperative ED visit. Finally, having >۳ preoperative ED visits was significantly associated with a ۹۰-day postoperative ED visit (OR ۹.۴۱, ۹۵% CI ۳.۶۸-۲۴.۰۶, P<۰.۰۰۱). Conclusion: Patients with a history of mental health disorder and those with a visit to the ED within ۱۲ months prior to the planned shoulder arthroscopy should be counseled preoperatively regarding appropriate direct contact with the treating surgical team following discharge to minimize postoperative ۹۰-day ED visits. Level of evidence: III

کلیدواژه ها:

postoperative surgical complications ، return to emergency room ، Risk factors ، Rotator Cuff ، Shoulder arthroscopy