Ling Kenny, Leatherwood William, Fassler Richelle, Burgan Jane, Komatsu David E, Wang Edward D
Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
Department of Orthopaedics, Stony Brook University, Stony Brook, NY, USA.
JSES Int. 2023 May 26;7(5):842-847. doi: 10.1016/j.jseint.2023.05.009. eCollection 2023 Sep.
Despite the rise in surgical volume for total shoulder arthroplasty (TSA) procedures, racial disparities exist in outcomes between White and Black populations. The purpose of this study was to compare 30-day postoperative complication rates between Black and White patients following TSA.
The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried for all patients who underwent TSA between 2015 and 2019. Patient demographics and comorbidities were compared between cohorts using bivariate analysis. Multivariate logistic regression, adjusted for all significantly associated patient demographics and comorbidities, was used to identify associations between Black or African American race and postoperative complications.
A total of 19,733 patients were included in the analysis, 18,669 (94.6%) patients in the White cohort and 1064 (5.4%) patients in the Black or African American cohort. Demographics and comorbidities that were significantly associated with Black or African American race were age 40-64 years ( < .001), body mass index ≥40 ( < .001), female gender ( < .001), American Society of Anesthesiologists classification ≥3 ( < .001), smoking status ( < .001), non-insulin and insulin dependent diabetes mellitus ( < .001), hypertension requiring medication ( < .001), disseminated cancer ( = .040), and operative duration ≥129 minutes ( = .002). Multivariate logistic regression identified Black or African American race to be independently associated with higher rates of readmission (odds ratio: 1.42, 95% confidence interval: 1.05-1.94; = .025).
Black or African American race was independently associated with higher rates of 30-day readmission following TSA.
尽管全肩关节置换术（TSA）的手术量有所增加，但白人和黑人人群在手术结果方面存在种族差异。本研究的目的是比较TSA术后黑人和白人患者30天的并发症发生率。
查询美国外科医师学会国家外科质量改进计划（NSQIP）数据库中2015年至2019年间接受TSA的所有患者。使用双变量分析比较队列之间的患者人口统计学和合并症。多因素逻辑回归在对所有显著相关的患者人口统计学和合并症进行校正后，用于确定黑人或非裔美国人种族与术后并发症之间的关联。
共有19733例患者纳入分析，白人队列中有18669例（94.6%）患者，黑人或非裔美国人队列中有1064例（5.4%）患者。与黑人或非裔美国人种族显著相关的人口统计学和合并症包括40 - 64岁（P <.001）、体重指数≥40（P <.001）、女性（P <.001）、美国麻醉医师协会分级≥3（P <.001）、吸烟状况（P <.001）、非胰岛素依赖型和胰岛素依赖型糖尿病（P <.001）、需要药物治疗的高血压（P <.001）、播散性癌症（P =.040）以及手术时间≥129分钟（P =.002）。多因素逻辑回归确定黑人或非裔美国人种族与再入院率较高独立相关（比值比：1.42，95%置信区间：1.05 - 1.94；P =.025）。
黑人或非裔美国人种族与TSA术后30天再入院率较高独立相关。
