Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 4 (1), 95-99

Sex Differences in Complications and Readmission Rates Following Shoulder Arthroplasty in the United States


Sex Differences in Complications and Readmission Rates Following Shoulder Arthroplasty in the United States

Brock M Knapp et al. JSES Int.


Introduction: Shoulder arthroplasty (SA) procedures are increasingly performed in the United States. However, there is a lack of data evaluating how patient sex may affect perioperative complications. The purpose of this study was to evaluate sex-based differences in 30-day postoperative complication and readmission rates after SA.

Methods: Total SA and reverse SA cases between 2012-2016 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. The 30-day complication rate, readmission rate, operation time, length of stay, and mortality were compared between women and men. Multivariable logistic regression analysis was performed to identify independent perioperative complications associated with patient sex.

Results: Of 12,530 SA cases, 6949 (55.4%) were female and 5499 (44.5%) were male. Compared with women, on average men were significantly younger, had lower body mass index, and were less likely to be functionally dependent, and less likely to have an American Society of Anesthesiologists score of 3+ (P < .001). Although overall complications and readmission rates between women and men were similar (3.4% vs. 3.7%, P = .489; 3.0% vs. 2.8%, P = .497), men were significantly less likely to develop urinary tract infections (UTIs; odds ratio [OR] 0.58, P = .032) and require transfusions (OR 0.49, P < .001) and had shorter lengths of stay (P < .001). However, men were significantly more likely to have a superficial surgical site infection (OR 2.63, P = .035) and 6.8 minute longer operating time (P < .001) compared with women.

Conclusion: Though the overall complication risk is similar between the sexes, their risk profiles are distinct. Men had decreased risk of UTI, blood transfusions, and shorter length of stay but increased risk of surgical site and longer operating time compared with women. This disparity should be discussed when counseling and risk-stratifying patients for SA.

Keywords: Shoulder arthroplasty; perioperative complications; readmissions; reverse total shoulder arthroplasty; sex differences; total shoulder arthroplasty.

Similar articles

See all similar articles


    1. Anthony C.A., Westermann R.W., Gao Y., Pugely A.J., Wolf B.R., Hettrich C.M. What are risk factors for 30-day morbidity and transfusion in total shoulder arthroplasty? A review of 1922 cases. Clin Orthop Relat Res. 2015;473:2099–2105. - PMC - PubMed
    1. Bohsali K.I., Wirth M.A., Rockwood C.A., Jr. Complications of total shoulder arthroplasty. J Bone Joint Surg Am. 2006;88:2279–2292. - PubMed
    1. Dalstrom D.J., Venkatarayappa I., Manternach A.L., Palcic M.S., Heyse B.A., Prayson M.J. Time-dependent contamination of opened sterile operating-room trays. J Bone Joint Surg Am. 2008;90:1022–1025. - PubMed
    1. Dunn J.C., Lanzi J., Kusnezov N., Bader J., Waterman B.R., Belmont P.J., Jr. Predictors of length of stay after elective total shoulder arthroplasty in the United States. J Shoulder Elbow Surg. 2015;24:754–759. - PubMed
    1. Epelboym I., Gawlas I., Lee J.A., Schrope B., Chabot J.A., Allendorf J.D. Limitations of ACS-NSQIP in reporting complications for patients undergoing pancreatectomy: underscoring the need for a pancreas-specific module. World J Surg. 2014;38:1461–1467. - PubMed

LinkOut - more resources