Perioperative medicine & outcomes
Retrospective analysis of the occurrence, potential risk factors and medical significance of pulmonary complications after total shoulder arthroplasty from the National Inpatient Sample database (2010–2019)
Authors' conclusion
The analysis revealed that the pneumonia rates decreased each year, whereas the PE rates remained relatively stable. A noticeable and consistent increase was found in respiratory failure from 2010 to 2019.
Study context
- Population
- US patients undergoing primary elective total shoulder arthroplasty (TSA), National Inpatient Sample (NIS) 2010–2019national estimate
- Participants
- 189,695 patients
- Exposure
- Patients with vs without perioperative pulmonary complications after TSA
- Outcome
- Incidence of pulmonary complications (pneumonia, respiratory failure, PE) after TSA
Methodological detailsNational Inpatient Sample database, trend-weighted national estimates
- National Inpatient Sample database
- Trend-weighted national estimates
Main finding
As reported in the abstract
Pulmonary complications (pneumonia, respiratory failure or PE)
Incidence of pulmonary complications after TSA
1.4%
95% CI 1.52%–1.64%
Observational data: associations, not effects.
Further findings
Comorbidities associated with pulmonary problems (risk factors)
| AOR (95% CI) | ||
|---|---|---|
| Ulcer | 9.43 (4.99–46.91) | |
| Pulmonary circulation disorders | 9.01 (4.56–31.92) | |
| Weight loss | 4.84 (2.15–10.88) | |
| Fluid and electrolyte disorders | 3.55 (2.55–4.95) | |
| Alcohol abuse | 1.56 (1.08–2.26) | |
| Congestive heart failure | 3.09 (1.83–5.24) | |
| Chronic pulmonary disease | 2.45 (1.60–3.75) | |
| Deficiency anaemia | 1.56 (1.08–2.26) | |
| Depression | 1.47 (1.03–2.11) | |
| Obesity | 1.46 (1.01–2.11) | |
| 0.050.21520Adjusted odds ratio (log scale) |
LOS
- Perioperative pulmonary problems associated with extended LOS
- + 3 days; 95% CI, 2-6
Hospitalisation costs
- Perioperative pulmonary problems associated with increased hospitalization costs
- + 20,514 US dollars; 95% CI, 14,109-35,281
Annual trends of pulmonary complications, 2010–2019
- Pneumonia rates decreased each year; Pulmonary embolism (PE) rates relatively stable; consistent increase in respiratory failure
Original publication
Retrospective analysis of the occurrence, potential risk factors and medical significance of pulmonary complications after total shoulder arthroplasty from the National Inpatient Sample database (2010–2019). Perioper Med (Lond). Published 10 January 2025. doi:10.
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