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Analysis of patient characteristics and outcomes related to distance traveled to a tertiary center for primary reverse shoulder arthroplasty
Introduction The reasons for referral and travel patterns are lacking for patients undergoing reverse shoulder arthroplasty (RSA). The purpose of this study was to compare comorbidities, surgical time, cost and complications between local and distant primary RSA patients. Methods Between 2007 and 20...
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| Published in: | Archives of orthopaedic and trauma surgery 2022-07, Vol.142 (7), p.1421-1428 |
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| container_title | Archives of orthopaedic and trauma surgery |
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| creator | Dubiel, Matthew J. Kolz, Joshua M. Tagliero, Adam J. Larson, Dirk R. Maradit Kremers, Hilal Cofield, Robert R. Sperling, John W. Sanchez-Sotelo, Joaquin |
| description | Introduction
The reasons for referral and travel patterns are lacking for patients undergoing reverse shoulder arthroplasty (RSA). The purpose of this study was to compare comorbidities, surgical time, cost and complications between local and distant primary RSA patients.
Methods
Between 2007 and 2015, 1,666 primary RSAs were performed at our institution. Patients were divided into two cohorts, local patients (from within Olmstead county and surrounding counties, 492 RSAs) and those from a distance (1,174 RSAs).
Results
Local patients were older (74 vs 71 years,
p
|
| doi_str_mv | 10.1007/s00402-021-03764-9 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2482672264</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2482672264</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-5e6b69e77722efe97b2cb7b1990762de227324f66efa37b0bf5e37084f4ea1073</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS1ERX_gBbpAltiwSeu_2ONlVQFFqsSGri3HuWZSZeLB16k079CHxtNMKeqCla17vnOs60PIOWcXnDFziYwpJhomeMOk0aqxb8gJV1I10nL99p_7MTlFvGeMi5Vl78ixlC0z0pgT8ng1-XGHA9IU6daXAaZCw9pnHwrkAcsQkPqpp2kuIW0AaYbRF-hpSbSvup8C0JL9A4zL0NNqLIPPOxpqGGQaU6bbPGz2owwPkBEortM89lX0uaxz2o4ey-49OYp-RPhwOM_I3dcvP69vmtsf375fX902QZq2NC3oTlswxggBEazpROhMx61lRosehDBSqKg1RC9Nx7rYgjRspaICz-viZ-TzkrvN6fcMWNxmwADj6CdIMzqhVkLXcK0q-ukVep_mXP-sUtpY1aqVlZUSCxVyQswQ3WFfx5nbd-WWrlztyj115Ww1fTxEz90G-r-W53IqIBcAqzT9gvzy9n9i_wCITKH1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2679454893</pqid></control><display><type>article</type><title>Analysis of patient characteristics and outcomes related to distance traveled to a tertiary center for primary reverse shoulder arthroplasty</title><source>Springer Nature:Jisc Collections:Springer Nature Read and Publish 2023-2025: Springer Reading List</source><creator>Dubiel, Matthew J. ; Kolz, Joshua M. ; Tagliero, Adam J. ; Larson, Dirk R. ; Maradit Kremers, Hilal ; Cofield, Robert R. ; Sperling, John W. ; Sanchez-Sotelo, Joaquin</creator><creatorcontrib>Dubiel, Matthew J. ; Kolz, Joshua M. ; Tagliero, Adam J. ; Larson, Dirk R. ; Maradit Kremers, Hilal ; Cofield, Robert R. ; Sperling, John W. ; Sanchez-Sotelo, Joaquin</creatorcontrib><description>Introduction
The reasons for referral and travel patterns are lacking for patients undergoing reverse shoulder arthroplasty (RSA). The purpose of this study was to compare comorbidities, surgical time, cost and complications between local and distant primary RSA patients.
Methods
Between 2007 and 2015, 1,666 primary RSAs were performed at our institution. Patients were divided into two cohorts, local patients (from within Olmstead county and surrounding counties, 492 RSAs) and those from a distance (1,174 RSAs).
Results
Local patients were older (74 vs 71 years,
p
< .001), more likely to have RSA for fracture, had a higher Charlson comorbidity score (3.8 vs 3.2,
p
< .001) and longer hospital stays (2.0 vs 1.8 days,
p
< 0.001) compared to referred patients. Referral patients required longer operative times (95 vs 88 min,
p
= .002), had higher hospitalization costs ($19,101 vs $18,735,
p
< .001), and had a higher rate of prior surgery (32% vs 24%,
p
< .001). There were no differences between cohorts regarding complications or need for reoperation.
Conclusions
Patients traveling from a distance to undergo primary RSA had longer operative times and were more likely to have had prior surgery than local patients. This may demonstrate the referral bias seen at large academic centers and should be considered when reviewing RSA outcomes, hospital performance, and calculating insurance reimbursement.
Level of evidence
Level IV.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-021-03764-9</identifier><identifier>PMID: 33507377</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Comorbidity ; Joint surgery ; Medical records ; Medicine ; Medicine & Public Health ; Orthopaedic Surgery ; Orthopedics ; Shoulder ; Surgical outcomes</subject><ispartof>Archives of orthopaedic and trauma surgery, 2022-07, Vol.142 (7), p.1421-1428</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-5e6b69e77722efe97b2cb7b1990762de227324f66efa37b0bf5e37084f4ea1073</citedby><cites>FETCH-LOGICAL-c375t-5e6b69e77722efe97b2cb7b1990762de227324f66efa37b0bf5e37084f4ea1073</cites><orcidid>0000-0003-3199-3247</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33507377$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dubiel, Matthew J.</creatorcontrib><creatorcontrib>Kolz, Joshua M.</creatorcontrib><creatorcontrib>Tagliero, Adam J.</creatorcontrib><creatorcontrib>Larson, Dirk R.</creatorcontrib><creatorcontrib>Maradit Kremers, Hilal</creatorcontrib><creatorcontrib>Cofield, Robert R.</creatorcontrib><creatorcontrib>Sperling, John W.</creatorcontrib><creatorcontrib>Sanchez-Sotelo, Joaquin</creatorcontrib><title>Analysis of patient characteristics and outcomes related to distance traveled to a tertiary center for primary reverse shoulder arthroplasty</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
The reasons for referral and travel patterns are lacking for patients undergoing reverse shoulder arthroplasty (RSA). The purpose of this study was to compare comorbidities, surgical time, cost and complications between local and distant primary RSA patients.
Methods
Between 2007 and 2015, 1,666 primary RSAs were performed at our institution. Patients were divided into two cohorts, local patients (from within Olmstead county and surrounding counties, 492 RSAs) and those from a distance (1,174 RSAs).
Results
Local patients were older (74 vs 71 years,
p
< .001), more likely to have RSA for fracture, had a higher Charlson comorbidity score (3.8 vs 3.2,
p
< .001) and longer hospital stays (2.0 vs 1.8 days,
p
< 0.001) compared to referred patients. Referral patients required longer operative times (95 vs 88 min,
p
= .002), had higher hospitalization costs ($19,101 vs $18,735,
p
< .001), and had a higher rate of prior surgery (32% vs 24%,
p
< .001). There were no differences between cohorts regarding complications or need for reoperation.
Conclusions
Patients traveling from a distance to undergo primary RSA had longer operative times and were more likely to have had prior surgery than local patients. This may demonstrate the referral bias seen at large academic centers and should be considered when reviewing RSA outcomes, hospital performance, and calculating insurance reimbursement.
Level of evidence
Level IV.</description><subject>Comorbidity</subject><subject>Joint surgery</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopaedic Surgery</subject><subject>Orthopedics</subject><subject>Shoulder</subject><subject>Surgical outcomes</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1DAUhS1ERX_gBbpAltiwSeu_2ONlVQFFqsSGri3HuWZSZeLB16k079CHxtNMKeqCla17vnOs60PIOWcXnDFziYwpJhomeMOk0aqxb8gJV1I10nL99p_7MTlFvGeMi5Vl78ixlC0z0pgT8ng1-XGHA9IU6daXAaZCw9pnHwrkAcsQkPqpp2kuIW0AaYbRF-hpSbSvup8C0JL9A4zL0NNqLIPPOxpqGGQaU6bbPGz2owwPkBEortM89lX0uaxz2o4ey-49OYp-RPhwOM_I3dcvP69vmtsf375fX902QZq2NC3oTlswxggBEazpROhMx61lRosehDBSqKg1RC9Nx7rYgjRspaICz-viZ-TzkrvN6fcMWNxmwADj6CdIMzqhVkLXcK0q-ukVep_mXP-sUtpY1aqVlZUSCxVyQswQ3WFfx5nbd-WWrlztyj115Ww1fTxEz90G-r-W53IqIBcAqzT9gvzy9n9i_wCITKH1</recordid><startdate>20220701</startdate><enddate>20220701</enddate><creator>Dubiel, Matthew J.</creator><creator>Kolz, Joshua M.</creator><creator>Tagliero, Adam J.</creator><creator>Larson, Dirk R.</creator><creator>Maradit Kremers, Hilal</creator><creator>Cofield, Robert R.</creator><creator>Sperling, John W.</creator><creator>Sanchez-Sotelo, Joaquin</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3199-3247</orcidid></search><sort><creationdate>20220701</creationdate><title>Analysis of patient characteristics and outcomes related to distance traveled to a tertiary center for primary reverse shoulder arthroplasty</title><author>Dubiel, Matthew J. ; Kolz, Joshua M. ; Tagliero, Adam J. ; Larson, Dirk R. ; Maradit Kremers, Hilal ; Cofield, Robert R. ; Sperling, John W. ; Sanchez-Sotelo, Joaquin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-5e6b69e77722efe97b2cb7b1990762de227324f66efa37b0bf5e37084f4ea1073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Comorbidity</topic><topic>Joint surgery</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopaedic Surgery</topic><topic>Orthopedics</topic><topic>Shoulder</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dubiel, Matthew J.</creatorcontrib><creatorcontrib>Kolz, Joshua M.</creatorcontrib><creatorcontrib>Tagliero, Adam J.</creatorcontrib><creatorcontrib>Larson, Dirk R.</creatorcontrib><creatorcontrib>Maradit Kremers, Hilal</creatorcontrib><creatorcontrib>Cofield, Robert R.</creatorcontrib><creatorcontrib>Sperling, John W.</creatorcontrib><creatorcontrib>Sanchez-Sotelo, Joaquin</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dubiel, Matthew J.</au><au>Kolz, Joshua M.</au><au>Tagliero, Adam J.</au><au>Larson, Dirk R.</au><au>Maradit Kremers, Hilal</au><au>Cofield, Robert R.</au><au>Sperling, John W.</au><au>Sanchez-Sotelo, Joaquin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of patient characteristics and outcomes related to distance traveled to a tertiary center for primary reverse shoulder arthroplasty</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2022-07-01</date><risdate>2022</risdate><volume>142</volume><issue>7</issue><spage>1421</spage><epage>1428</epage><pages>1421-1428</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
The reasons for referral and travel patterns are lacking for patients undergoing reverse shoulder arthroplasty (RSA). The purpose of this study was to compare comorbidities, surgical time, cost and complications between local and distant primary RSA patients.
Methods
Between 2007 and 2015, 1,666 primary RSAs were performed at our institution. Patients were divided into two cohorts, local patients (from within Olmstead county and surrounding counties, 492 RSAs) and those from a distance (1,174 RSAs).
Results
Local patients were older (74 vs 71 years,
p
< .001), more likely to have RSA for fracture, had a higher Charlson comorbidity score (3.8 vs 3.2,
p
< .001) and longer hospital stays (2.0 vs 1.8 days,
p
< 0.001) compared to referred patients. Referral patients required longer operative times (95 vs 88 min,
p
= .002), had higher hospitalization costs ($19,101 vs $18,735,
p
< .001), and had a higher rate of prior surgery (32% vs 24%,
p
< .001). There were no differences between cohorts regarding complications or need for reoperation.
Conclusions
Patients traveling from a distance to undergo primary RSA had longer operative times and were more likely to have had prior surgery than local patients. This may demonstrate the referral bias seen at large academic centers and should be considered when reviewing RSA outcomes, hospital performance, and calculating insurance reimbursement.
Level of evidence
Level IV.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33507377</pmid><doi>10.1007/s00402-021-03764-9</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3199-3247</orcidid></addata></record> |
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| language | eng |
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| source | Springer Nature:Jisc Collections:Springer Nature Read and Publish 2023-2025: Springer Reading List |
| subjects | Comorbidity Joint surgery Medical records Medicine Medicine & Public Health Orthopaedic Surgery Orthopedics Shoulder Surgical outcomes |
| title | Analysis of patient characteristics and outcomes related to distance traveled to a tertiary center for primary reverse shoulder arthroplasty |
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