Racial and ethnic disparities in short-stay primary total shoulder arthroplasty.

BACKGROUND

There is a paucity of literature evaluating the utilization of short-stay total shoulder arthroplasty (TSA) in different racial groups. The purpose of this study is to compare short-stay TSA utilization and postoperative outcomes across racial groups.

METHODS

The National Surgical Quality Improvement Program (NSQIP) database was queried from 2010 to 2018 to identify patients who underwent primary short-stay TSA, defined as a length of stay of less than 2 midnights. Annual proportions of short-stay TSA, demographic variables, preoperative comorbidities, and postoperative complications were compared across groups.

RESULTS

All racial groups showed increases in the proportion of short-stay TSA cases over time, but this increase was most evident in Whites. Hispanics had increased rates of pneumonia (0.8% vs. 0.2%;  = 0.002) and transfusion (2.0% vs 1.0%;  = 0.015) compared to Whites, but no other differences in outcomes were observed between groups.

DISCUSSION

Postoperative outcomes were similar across groups despite differing comorbidity profiles, suggesting that short-stay TSA is being implemented appropriately based on perceived preoperative risk. However, differences in utilization across groups suggest that underlying disparities may exist. Given the continued increase in short-stay TSA procedures, opportunities to resolve racial disparities are essential in mitigating the effects of social determinants of health in minority patient groups.