title: Patient age is a factor in early outcomes after shoulder arthroplasty.
abstract: BACKGROUND
  Elderly and young patients alike are undergoing shoulder replacement at increased rates. In an era of outcomes reporting, risk adjustment, and cost containment, identifying patients likely to have adverse events is increasingly important. Our objective was to determine whether patient age is independently associated with postoperative in-hospital complications or increased hospital charges after shoulder arthroplasty.
  
  
  METHODS
  We used the Nationwide Inpatient Sample to analyze 58,790 patients undergoing total shoulder arthroplasty or hemiarthroplasty between 2000 and 2008. Multivariate analysis with logistic regression modeling was used to compare groups. Our objective was to determine whether age had an independent impact on the likelihood of postoperative in-hospital complications, mortality rate, length of stay, or charges after shoulder arthroplasty.
  
  
  RESULTS
  Patients aged 80 years or older had an increased in-hospital mortality rate (0.5%) compared with patients aged 50 to 79 years (0.1%) and patients aged younger than 50 years (0.1%). Predictors of death included female gender, total shoulder arthroplasty versus hemiarthroplasty, and Deyo score. Increased age was associated with slightly increased hospital charges. Length of stay was longer in patients aged 80 years or older compared with younger patients. After shoulder arthroplasty, postoperative anemia occurred more often in patients aged 80 years or older. Other postoperative complications including pulmonary embolism, infection, and cardiac complications were similar among groups.
  
  
  CONCLUSIONS
  Older patients tend to have longer hospital stays, an increased incidence of postoperative anemia, and slightly higher charges after shoulder arthroplasty. Advanced age is not associated with an increased incidence of pulmonary embolism, infection, and cardiac complications. Further research is warranted to explain the relationship between age and early postoperative outcomes.
authors: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
authors: Justin W
authors: JW
authors: Griffin
authors: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
authors: Michael M
authors: MM
authors: Hadeed
authors: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
authors: Wendy M
authors: WM
authors: Novicoff
authors: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
authors: James A
authors: JA
authors: Browne
authors: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: sfb2e@virginia.edu.
authors: Stephen F
authors: SF
authors: Brockmeier
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D012785:Shoulder Joint / Q000601:surgery*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Shoulder arthroplasty; age; complications; cost analysis; length of stay