Factors Associated with In-hospital Pulmonary Embolism Following Shoulder Arthroplasty
Bradley L. Young, BS,1 Mariano E. Menendez, MD,1 Dustin K. Baker, BS,1 and Brent A. Ponce, MD1Shoulder
Background
Despite pulmonary embolism (PE) being a feared complication after shoulder arthroplasty, little is known about its perioperative associated factors.
Materials and Methods
We used the Nationwide Inpatient Sample to gather a sample of 422,372 patients who underwent shoulder arthroplasty between 2002 and 2011. This population was divided into two cohorts based on those who experienced perioperative PE (0.25%) and those who did not. Demographics were compiled for both cohorts. Multivariable logistic regression analysis was used to account for confounding variables and determine significant predictors of perioperative PE.
Results
After adjusting for patient demographic and clinical variables in multivariable regression modeling, the top 4 independent predictors for PE were primary diagnosis of proximal humerus fracture, deficiency anemia, congestive heart failure, and chronic lung disease. Other pertinent risk factors included increasing age, obesity, fluid and electrolyte abnormalities, undergoing TSA rather than HA, and subsequent days of post-operative care.
Conclusions
Knowledge of these factors might help in preoperative counseling and prove useful for implementation of quality improvement strategies to reduce its occurrence. Surgeons may consider initiating thromboprophylaxis in patients with any of the aforementioned comorbidities.
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