Complications More Likely After Inpatient Rotator Cuff Repair

Inpatient rotator cuff repair comes with a higher risk of complications compared with an outpatient procedure, new study finds.

In the study, “Inpatient Arthroscopic Rotator Cuff Repair Is Associated With Higher Postoperative Complications Compared With Same-Day Discharge: A Matched Cohort Analysis,” published in the January 2021 issue of the journal Arthroscopy, researchers used an administrative claims database to identify patients undergoing arthroscopic rotator cuff repair from 2007 to 2015.

For the study, researchers classified patients based on length of hospital stay with inpatient rotator cuff repair which was defined as patients with one or more days in the hospital while outpatient rotator cuff repair was defined for the purposes of the study as patients who were discharged day of surgery.

The research team matched patient groups according to age, sex, Charlson Comorbidity Index (CCI), and various medical comorbidities.

The researchers then compared patient factors, concomitant procedures, total adverse events, medical adverse events, and surgical adverse events between the two groups.

The research team enrolled 2,812 patients.

After all the data was assembled, the research team found that the incidence of total adverse events for the inpatient vs outpatient group was 8.9% vs. 3.6%, p < .0001, surgical adverse events (SAEs) (2.7% vs. 0.9%, p = .0002), and medical adverse events (MAEs) (6.4% vs. 3.0%, p < .0001) within 90 days of the arthroscopic rotator cuff repair.

Inpatient rotator cuff repair, greater Charlson Comorbidity Index, and anxiety or depression were independent predictors for total adverse events, while open biceps tenodesis and inpatient rotator cuff repair were predictive of surgical adverse events.

The analysis also showed the greater Charlson Comorbidity Index, anxiety or depression and inpatient rotator cuff repair were independent predictors for medical adverse events.

The researchers wrote, “Inpatient arthroscopic rotator cuff repair is associated with increased risk of 90-day postoperative complications compared with outpatient. However, there is no difference for all-cause or pain-related emergency department visits within 90 days after surgery. In addition, the multivariate model identified inpatient rotator cuff repair, greater Charlson Comorbidity Index, and diagnosis of anxiety or depression as independent risk factors for 90-day total adverse events after arthroscopic rotator cuff repair.