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The use of tobacco is a modifiable risk factor for poor outcomes and readmissions after shoulder arthroplasty.

Publication ,  Journal Article
Schwartz, AM; Farley, KX; Boden, SH; Wilson, JM; Daly, CA; Gottschalk, MB; Wagner, ER
Published in: Bone Joint J
November 2020

AIMS: The impact of tobacco use on readmission and medical and surgical complications has been documented in hip and knee arthroplasty. However, there remains little information about the effect of smoking on the outcome after total shoulder arthroplasty (TSA). We hypothesized that active smokers are at an increased risk of poor medical and surgial outcomes after TSA. METHODS: Data for patients who underwent arthroplasty of the shoulder in the USA between January 2011 and December 2015 were obtained from the National Readmission Database, and 90-day readmissions and complications were documented using validated coding methods. Multivariate regression analysis was performed to quantify the risk of smoking on the outcome after TSA, while controlling for patient demographics, comorbidities, and hospital-level confounding factors. RESULTS: A total of 196,325 non-smokers (93.1%) and 14,461 smokers (6.9%) underwent TSA during the five-year study period. Smokers had significantly increased rates of 30- and 90-day readmission (p = 0.025 and 0.001, respectively), revision within 90 days (p < 0.001), infection (p < 0.001), wound complications (p < 0.001), and instability of the prosthesis (p < 0.001). They were also at significantly greater risk of suffering from pneumonia (p < 0.001), sepsis (p = 0.001), and myocardial infarction (p < 0.001), postoperatively. CONCLUSION: Smokers have an increased risk of readmission and medical and surgical complications after TSA. These risks are similar to those found for smokers after hip and knee arthroplasty. Many surgeons choose to avoid these elective procedures in patients who smoke. The increased risks should be considered when counselling patients who smoke before undertaking TSA. Cite this article: Bone Joint J 2020;102-B(11):1549-1554.

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Published In

Bone Joint J

DOI

EISSN

2049-4408

Publication Date

November 2020

Volume

102-B

Issue

11

Start / End Page

1549 / 1554

Location

England

Related Subject Headings

  • Treatment Outcome
  • Tobacco Smoking
  • Risk Factors
  • Patient Readmission
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cigarette Smoking
  • Arthroplasty, Replacement, Shoulder
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schwartz, A. M., Farley, K. X., Boden, S. H., Wilson, J. M., Daly, C. A., Gottschalk, M. B., & Wagner, E. R. (2020). The use of tobacco is a modifiable risk factor for poor outcomes and readmissions after shoulder arthroplasty. Bone Joint J, 102-B(11), 1549–1554. https://doi.org/10.1302/0301-620X.102B11.BJJ-2020-0599.R1
Schwartz, Andrew M., Kevin Xavier Farley, Susanne H. Boden, Jacob M. Wilson, Charles A. Daly, Michael B. Gottschalk, and Eric R. Wagner. “The use of tobacco is a modifiable risk factor for poor outcomes and readmissions after shoulder arthroplasty.Bone Joint J 102-B, no. 11 (November 2020): 1549–54. https://doi.org/10.1302/0301-620X.102B11.BJJ-2020-0599.R1.
Schwartz AM, Farley KX, Boden SH, Wilson JM, Daly CA, Gottschalk MB, et al. The use of tobacco is a modifiable risk factor for poor outcomes and readmissions after shoulder arthroplasty. Bone Joint J. 2020 Nov;102-B(11):1549–54.
Schwartz, Andrew M., et al. “The use of tobacco is a modifiable risk factor for poor outcomes and readmissions after shoulder arthroplasty.Bone Joint J, vol. 102-B, no. 11, Nov. 2020, pp. 1549–54. Pubmed, doi:10.1302/0301-620X.102B11.BJJ-2020-0599.R1.
Schwartz AM, Farley KX, Boden SH, Wilson JM, Daly CA, Gottschalk MB, Wagner ER. The use of tobacco is a modifiable risk factor for poor outcomes and readmissions after shoulder arthroplasty. Bone Joint J. 2020 Nov;102-B(11):1549–1554.

Published In

Bone Joint J

DOI

EISSN

2049-4408

Publication Date

November 2020

Volume

102-B

Issue

11

Start / End Page

1549 / 1554

Location

England

Related Subject Headings

  • Treatment Outcome
  • Tobacco Smoking
  • Risk Factors
  • Patient Readmission
  • Middle Aged
  • Male
  • Humans
  • Female
  • Cigarette Smoking
  • Arthroplasty, Replacement, Shoulder