title: Factors associated with in-hospital pulmonary embolism after shoulder arthroplasty.
abstract: BACKGROUND
  Despite that pulmonary embolism (PE) is a feared complication after shoulder arthroplasty, little is known about its perioperative associated factors.
  
  
  METHODS
  We used the Nationwide Inpatient Sample to gather a sample of 422,372 patients who underwent shoulder arthroplasty between 2002 and 2011. This population was divided into 2 cohorts on the basis of those who experienced perioperative PE (0.25%) and those who did not. Demographics were compiled for both cohorts. Multivariable logistic regression analysis was used to account for confounding variables and to determine significant predictors of perioperative PE.
  
  
  RESULTS
  After adjusting for patient demographic and clinical variables in multivariable regression modeling, the top 4 independent predictors for PE were primary diagnosis of proximal humerus fracture, deficiency anemia, congestive heart failure, and chronic lung disease. Other pertinent risk factors included increasing age, obesity, fluid and electrolyte abnormalities, undergoing total shoulder arthroplasty rather than hemiarthroplasty, and subsequent days of postoperative care.
  
  
  CONCLUSIONS
  Knowledge of these factors might help in preoperative counseling and prove useful for implementation of quality improvement strategies to reduce the occurrence of PE. Surgeons may consider initiating thromboprophylaxis in patients with any of the aforementioned comorbidities.
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Bradley L
authors.initials: BL
authors.lastname: Young
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Mariano E
authors.initials: ME
authors.lastname: Menendez
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Dustin K
authors.initials: DK
authors.lastname: Baker
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: bponce@uabmc.edu.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Ponce
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D062785:Hemiarthroplasty / Q000009:adverse effects; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D012785:Shoulder Joint / Q000601:surgery*; D014481:United States / Q000453:epidemiology
keywords: Nationwide Inpatient Sample; perioperative complications; pulmonary embolism; shoulder arthroplasty