Predictors of Mortality Following Shoulder Arthroplasty

Peter J Dacombe, Luke Harries, Philip A McCann, Mark Crowther, Iain Packham, Partha Sarangi, Michael R Whitehouse*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

4 Downloads (Pure)

Abstract

Introduction
This study aims to determine 30-day, 90-day and 1 year mortality following shoulder arthroplasty and identify predictors of mortality.

Materials and methods
All shoulder arthroplasty cases performed at the host institution, between 2012 and 2018 were included. A review of patient records was completed to identify demographic data, Charlson comorbidity index, date of death and factors associated with mortality.Mortality analysis was undertaken using 1-Kaplan Meier estimates with 95% confidence intervals. Comparative analysis was performed for mortality following shoulder arthroplasty for elective vs. trauma and for primary vs. revision surgery. A multiple regression analysis was conducted to determine which factors were associated with increased mortality risk.

Results
640 shoulder arthroplasty cases were performed in 566 patients. There were 44 deaths, 1 occurred within 90 days and 13 within 1 year. Trauma procedures had a hazard ratio of 5.3 (95% CI 1.9 to 15.0) for mortality compared to elective procedures (5 year survival trauma 78.6% (95% CI 60.7 to 89.0); elective 91.8% (95% CI 88.1 to 94.4). 1-year mortality was predicted by presence of malignancy, liver failure, cardiac failure, peptic ulcer, trauma surgery, revision surgery, intra-operative complication, transfusion and increased length of stay.

Discussion
30-day, 90-day and 1-year mortality following shoulder arthroplasty were 0%, 0.16% and 2%; trauma procedures had a hazard ratio of 5.3 for 1-year mortality when compared to elective surgery. Malignancy, cardiac failure, liver failure, peptic ulcer and trauma surgery are associated with an increased risk of 1-year mortality.
Original languageEnglish
Pages (from-to)179-183
Number of pages5
JournalJournal of Orthopaedics
Volume22
Early online date4 May 2020
DOIs
Publication statusE-pub ahead of print - 4 May 2020

Keywords

  • Shoulder
  • Arthroplasty
  • Outcome
  • Mortality

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