Risk factors for and timing of adverse events after revision total shoulder arthroplasty

Aakash Keswani, Debbie Chi, Andrew J. Lovy, Daniel A. London, Paul J. Cagle, Bradford O. Parsons, Joseph A. Bosco

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Despite increasing rates of revision total shoulder arthroplasty (RTSA), there is a paucity of literature on optimizing perioperative outcomes. The purposes of this study were to identify risk factors for unplanned readmission and perioperative complications following RTSA, risk-stratify patients based on these risk factors, and assess timing of complications. Methods: Bivariate and multivariate analyses of risk factors were assessed on RTSA patients from the ACS-NSQIP database from 2011 to 2015. Patients were risk-stratified and timing of severe adverse events and cause of readmission were evaluated. Results: Of 809 RTSA patients, 61 suffered a perioperative complication or readmission within 30 days of discharge. Multivariate analysis identified operative time, BMI > 40, infection etiology, high white blood cell count, and low hematocrit as significant independent risk factors for 30-day complications or readmission after RTSA (p ≤ 0.05). Having at least one significant risk factor was associated with 2.71 times risk of complication or readmission within 15 days compared to having no risk factors (p < 0.001). The majority of unplanned readmission, return to the operating room, open/deep wound infection, and sepsis/septic shock occurred within two weeks of RTSA. Discussion: Patients at high risk of complications and readmission after RTSA should be identified and optimized preoperatively to improve outcomes and lower costs.

Original languageEnglish
Pages (from-to)332-343
Number of pages12
JournalShoulder and Elbow
Issue number5
StatePublished - 1 Oct 2019


  • complications
  • length of stay
  • readmission
  • revision total shoulder arthroplasty
  • risk factors
  • total shoulder arthroplasty


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