An Analysis of Adult Patient Risk Factors and Complications Within 30 Days After Arthroscopic Shoulder Surgery

摘要

Purpose: To identify risk factors of adult patients predisposing them to the most common complications that occur within 30 days after arthroscopic shoulder surgery. Methods: The National Surgical Quality Improvement Program database was queried for arthroscopic shoulder procedures. Complications and their frequency were calculated. Multivariate analysis was used to identify risk factors of adult patients predisposing them to complications. Risk factors for reoperation and characteristics of patients undergoing repair procedures were also analyzed. Results: Among 10,255 cases of shoulder arthroscopy, 119 complications were reported in 103 cases within 30 days of surgery. The rates of any, major, and minor complications were 1%, 0.57%, and 0.53%, respectively. Return to the operating room (29% of all complications) was the most frequent complication. With risk adjustment, the odds of complications developing were higher for patients older than 60 years (adjusted odds ratio [AOR], 3.47; P = .03), patients with a surgical time greater than 1.5 hours (AOR, 1.93; P = .01), patients with chronic obstructive pulmonary disease (COPD; AOR, 2.76; P = .03), patients with an inpatient status (AOR, 2.72; P < .01), patients with disseminated cancer (AOR, 21.9; P < .01), and current smokers (AOR, 1.94; P = .01). The presence of COPD (AOR, 4.67; P = .04) was a significant predictor for reoperation within 30 days. Repair procedures did not increase the risk of complications compared with non-repair. Male patients, patients aged younger than 30 years, nondiabetic patients, and nonsmokers were more likely to undergo repair procedures (P < .05 for all). Conclusions: Shoulder arthroscopy has a 1.0% thirty-day complication rate, with the most common complication being return to the operating room (29% of all complications). Age older than 60 years, surgical time greater than 90 minutes, COPD, inpatient status, disseminated cancer, and current smoking all increased a patient's risk of complications. Patients undergoing repair procedures were not at increased risk. Pulmonary comorbidity increases the risk of reoperation within 30 days. Patients undergoing repair procedures tend to be younger and carry fewer risk factors for complications.