National utilization of reverse total shoulder arthroplasty in the United States
National utilization of reverse total shoulder arthroplasty in the United States
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DOI：
10.1016/j.jse.2014.08.026
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发表时间：
2015-01-01
影响因子：
3
通讯作者：
Gulotta, Lawrence V.
中科院分区：
文献类型：
--
作者：
Schairer, William W.;Nwachukwu, Benedict U.;Gulotta, Lawrence V.
背景资料：在过去的十年中，肩关节置换术在美国的使用率大幅增加，部分原因是反式肩关节置换术（RSA）的接受度不断提高。本研究比较了肩关节半髋关节置换术，全肩关节置换术（TSA），和RSA.Methods的国家利用和适应症：全国住院患者样本被用来确定肩关节置换术在2011年在美国进行的程序。识别每种肩关节置换术的适应症诊断、人口统计学和医院特征。多变量回归分析确定了与长期住院相关的因素。结果：估计有66,485例肩关节置换术（33% RSA，44% TSA和23%半关节置换术）。RSA的常见诊断是肩袖撕裂和关节炎（80%）和肱骨近端骨折（10%）。在93%的病例中，对骨关节炎进行了TSA。半关节置换术用于治疗骨关节炎（45%）和肱骨近端骨折（38%）。四分之一的肱骨近端骨折行关节置换术，接受RSA相比，69.8%，接受半关节置换术。非创伤性骨折患者的死亡率为0.08%，而肱骨近端骨折患者的死亡率为0.53%（P <0.001）。合并症的老年患者往往有较长的住院时间，因为那些与政府insurance.Conclusions：在美国，在2011年的所有肩关节置换术的三分之一的RSA占。尽管大多数RSA用于肩袖撕裂关节病，但四分之一的肱骨近端骨折采用RSA治疗，这表明这种相对较新的手术在美国得到了广泛应用。(C)2015年《肩肘外科杂志》董事会。
Background: The substantial increase in the utilization of shoulder arthroplasty in the United States during the past decade is partly attributable to the growing acceptance of reverse shoulder arthroplasty (RSA). This study compared the national utilization of and indications for shoulder hemiarthroplasty, total shoulder arthroplasty (TSA), and RSA.Methods: The Nationwide Inpatient Sample was used to identify shoulder arthroplasty procedures performed in the United States in 2011. Indicating diagnoses, demographics, and hospital characteristics were identified for each shoulder arthroplasty procedure. Multivariable regression identified factors associated with long hospital stays.Results: An estimated 66,485 shoulder arthroplasty procedures were identified (33% RSA, 44% TSA, and 23% hemiarthroplasty). Common diagnoses for RSA were rotator cuff tear and arthritis (80%) and proximal humerus fracture (10%). TSA was performed for osteoarthritis in 93% of cases. Hemiarthroplasty was performed for osteoarthritis (45%) and proximal humerus fracture (38%). One quarter of proximal humerus fractures treated with arthroplasty received RSA compared with 69.8% that underwent hemiarthroplasty. Mortality occurred in 0.08% of patients with atraumatic diagnoses but in 0.53% of patients with proximal humerus fractures (P < .001). Older patients with comorbidities often had longer hospital stays, as did those with government insurance.Conclusions: RSAs accounted for one third of all shoulder arthroplasty procedures in the United States in 2011. Whereas the majority of RSAs are performed for rotator cuff tear arthropathy, one quarter of proximal humerus fractures are treated with RSA, suggesting the strong uptake of this relatively new procedure in the United States. (C) 2015 Journal of Shoulder and Elbow Surgery Board of Trustees.