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Frank McCormick1, Benedict U Nwachukwu2, Emmanouil B. S. Kiriakopoulos1, William W Schairer2, Matthew T Provencher3, Jonathan Levy1
1 Holy Cross Orthopedic Institute, Holy Cross Hospital, Fort Lauderdale, FL, USA
2 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
3 Department of Sports Medicine, Massachusetts General Hospital, Boston, MA, USA
Correspondence Address:
Frank McCormick
5597 North Dixie Highway, Fort Lauderdale, FL 33334
USA
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/0973-6042.167938
Introduction: The in-hospital mortality rate after total shoulder arthroplasty (TSA) is unknown. The purpose of this study is to quantify the in-patient mortality rates and associated demographic risk factors for patients undergoing a TSA from 2005 to 2011 using a comprehensive Medicare registry database.
Materials and Methods: We conducted a retrospective review of the Medicare database within the PearlDiver database. The PearlDiver database is a publicly available Health Insurance Portability and Accountability Act-compliant national database that captures 100% of the Medicare hospital data for TSA between 2005 and 2011. Using International Classification of Diseases, Ninth Revision codes for TSA we identified a dataset of patients undergoing TSA as well as a subset of those for whom there was a death discharge (i.e., in-patient death). Risk for this outcome was further quantified by age, gender and year. Linear regression was performed to identify risk factors for the primary outcome.
Results: A total of 101,323 patients underwent 125,813 TSAs between 2005 and 2011. There were 113 in-patient mortalities during this period. Thus the incidence of death was 0.09%. Increasing age was a significant risk factor for mortality (P = 0.03). Gender and year of procedure were not significant risk factors for mortality.
Conclusion: The incidence of in-patient mortality for Medicare patients undergoing TSA between 2005 and 2011 was <1 in 1000 surgeries. Increased age is a significant predictor of mortality.
Level 4: Retrospective analysis
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