Thursday, November 3, 2016

Increased total shoulder complication rate for smokers and patients with ASA of III

Total shoulder arthroplasty: risk factors for intraoperative and postoperative complications in patients with primary arthritis

These authors correlated patient-specific factors in 275 patients (76 men, 199 women) with an average age of 68 years (range, 51-85 years) with the number and severity of all complications after total shoulder arthroplasty.

They identified 27  complications (9.8%) in 275 shoulder arthroplasties.

Patients with an ASA score of III showed an increased likelihood of having a surgical complication compared with the control group with ASAscores of 1 and 2 (odds ratio, 4.28; 95% confidence interval, 1.79-10.20; P < .01).

Smokers (> 10 cigarettes/day) were more prone to surgical complications than nonsmokers (odds ratio, 5.08; 95% confidence interval, 1.96-13.11; P = .02).

Comment: We often refer to the 4 Ps that affect the outcome of surgery: the Patient, the Procedure, the type of shoulder Problem, and the Physician performing the surgery. This study identifies smoking and ASA classification as two important Patient factors.