Factors Affecting Cost, Outcomes, and Tendon Healing After Arthroscopic Rotator Cuff Repair
Factors influencing direct clinical costs of outpatient arthroscopic rotator cuff repair surgery
Immediate costs of mini-open versus arthroscopic rotator cuff repair in an Asian population
Quantifying the Economic Impact of Provider Volume Through Adverse Events
The burden of rotator cuff surgery in Italy: a nationwide registry study
The Incidence of Subsequent Surgery After Outpatient Arthroscopic Rotator Cuff Repair
The purpose of this study was to quantify the incidence and risk factors associated with subsequent shoulder procedures in individuals undergoing outpatient ARCR. On the basis of existing literature,27-30 we hypothesized that age and the exis- tence of a Workers’ Compensation claim would be associated with the need for subsequent surgical procedures.
For this study, diagnoses and procedures were classified by Current Procedural Terminology (CPT), fourth edition, and International Classification ofDiseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. The American Medical Association officially introduced CPT code 29827 for ARCR in 2003. We queried the database from 2003 through 2014 to identify all isolated ARCRs performed. Any patient with additional shoulder CPT codes at the time of initial RCR was excluded, with the exception of subacromial decompression (CPT code 29826).
They identified by this study1,920 unique patients who underwent ARCR between 2003 and 2012. Elimination of patients with concomitant CPT codes other than acromioplasty and those with evidence of prior ipsilateral shoulder procedures yielded the final sample of 30,430 patients.
Similar to previous studies, our study used International Classification of Diseases, Ninth Revision (ICD-9) codes of 305.1 and V15.62 to identify patients with a history of tobacco use.
Differences in categorical variables were evaluated with the Fisher exact test (when possible) or c2 analysis. Multivariate logistic regression that controlled for age, sex, insurance, tobacco use, and acromioplasty at the time of initial surgery was performed to determine independent risk factors for subsequent surgery. P < .05 was considered statistically significant. This study has been conducted by a method that provided to examine the New York Statewide Planning and Research Cooperative Systems outpatient database from 2003 through 2014 to identify patients undergoing isolated ARCR with or without concomitant acromioplasty. Patients were longitudinally followed up for a minimum of 2 years to determine the incidence of subsequent ipsilateral shoulder surgery. Finally resulted that, on 30,430 patients, a total of 1,826 patients (6%) underwent subsequent ipsilateral outpatient shoulder surgery a mean of 24.3+/-27.1months after the initial ARCR. Of patients who underwent repeat surgery, 57.3% underwent a revision cuff repair. Patients who underwent additional outpatient shoulder surgery were significantly younger (53.7 +/- 10.9 years v 56.8 +/- 11.5 years, P < .001). Tobacco use was associated with an increased rate of subsequent surgery (7.3% v 5.9%P=.044) and accelerated time to reoperation (16.9 months v 24.7 months, P<.001). Independent risk factors for subsequent ipsilateral surgery after initial ARCR were presence of a Workers’ Compensation claim (odds ratio, 2.11; 95% confidence interval, 1.89-2.36; P<.001) and initial ARCR without acromioplasty (odds ratio, 1.20; 95% confidence interval,1.89-2.36;P<.0001). Finally, they identified a 6.0% incidence of repeat ipsilateral surgery after isolated ARCR. Although reasons for reoperation are likely multifactorial, younger age, Workers’ Compensation claim, and absence of acromioplasty at the time of initial ARCR remained independent predictors of subsequent outpatient procedures, whereas a history of tobacco use was associated with accelerated time to subsequent surgery [/av_textblock] [/av_one_half][av_button_big label='Complete article here' description_pos='below' link='manually,https://www.ncbi.nlm.nih.gov/pubmed/27039214' link_target='' icon_select='no' icon='ue800' font='entypo-fontello' custom_font='#ffffff' color='theme-color' custom_bg='#444444' color_hover='theme-color' custom_bg_hover='#444444' av_uid='av-jnug0h7v' admin_preview_bg=''][/av_button_big]