Complications, mortality and readmission during the first year after surgery in subjects treated with a reversed shoulder arthroplasty at Ramón y Cajal Hospital between 2013 and 2019

Abstract

41 p.La prótesis invertida de hombro (PIH) es una buena alternativa para los sujetos con artropatía degenerativa de la articulación glenohumeral y manguito rotador insuficiente o con fracturas complejas de humero proximal. Sin embargo, se ha identificado una tasa elevada de complicaciones precoces. El objetivo de este estudio es determinar la tasa de complicaciones, reingresos y mortalidad durante el primer año postquirúrgico en pacientes intervenidos con una PIH en el Hospital Ramón y Cajal. Se ha realizado un análisis retrospectivo de una serie de 151 pacientes consecutivos intervenidos con una PIH entre 2013 y 2019, 11 de ellos con afectación bilateral, registrándose un total de 161 artroplastias (124 en mujeres y 37 varones, edad media= 73±10 años). Se registraron los antecedentes epidemiológicos, la valoración preoperatoria y la información de la cirugía, así como, los resultados postquirúrgicos a un año. La tasa de complicaciones, reingreso, re-intervención y mortalidad asociada a esta técnica ha sido 8,07%, 11,8%, 6,21% y 0,62%, respectivamente. El índice de reingresos registrados ha sido superior en varones frente a mujeres (p= 0,002, OR=4,73 [IC 95%: 1,75-12]), en los operados por artropatía de manguito (p=0,022, OR=5,95 [1,29-27,02]) y en diabéticos (p=0,046 OR=3,163 [1,02-9,82]). Por otro lado, la tasa de re intervenciones ha sido superior entre los diabéticos (p=0,029, OR=4 [1,15-22,91]) y en las cirugías de recambio (p = 0,046, OR=6,1 [1,03-36,1]). Los resultados clínicos asociados a la PIH son favorables y la tasa de complicaciones es equiparable a otros tipos de artroplastias, pudiendo considerarla una técnica adecuada en patología de hombro.The reverse shoulder arthroplasty (RSA) is a good alternative for patients with degenerative arthropathy of the glenohumeral joint and insufficient rotator cuff or with complex fractures of the proximal humerus. However, a high rate of early complications has been identified. The aim of this study is to determine the rate of complications, readmissions and mortality during the first year after surgery in patients who underwent RSA at Hospital Ramón y Cajal. A retrospective analysis was carried out of a series of 151 consecutive patients who underwent RSA between 2013 and 2019, 11 of them with bilateral involvement, registering a total of 161 arthroplasties (124 in women and 37 in men, mean age = 73 ± 10 years). Epidemiological history, preoperative assessment and surgery information were recorded, as well as postoperative results at one year. The rate of complications, readmission, re-intervention and mortality associated with this technique has been 8.07%, 11.8%, 6.21% and 0.62%, respectively. The rate of readmissions registered has been higher in men than in women (p = 0.002, OR = 4.73 [95% CI: 1.75-12]), in those operated due to cuff arthropathy (p = 0.022, OR = 5.95 [1.29- 27.02]) and in diabetics (p = 0.046 OR = 3.163 [1.02-9.82]). On the other hand, the rate of re-interventions has been higher among diabetics (p = 0.029, OR = 4 [1.15-22.91]) and in replacement surgeries (p = 0.046, OR = 6.1 [1.03-36.1]). The clinical outcomes associated with RSA are potentially positive and the complication rate is comparable to other types of arthroplasties, allowing it to be considered as an adequate technique in shoulder pathology.Grado en Medicin