The association of alcohol use disorder with revision rates and post-operative complications in total shoulder arthroplasty

Document Type

Journal Article

Publication Date

7-1-2024

Journal

Shoulder & elbow

Volume

16

Issue

3

DOI

10.1177/17585732231165526

Keywords

Alcohol use disorder; complications; retrospective study; revision; total shoulder arthroplasty

Abstract

BACKGROUND: Alcohol use disorder (AUD) is the most prevalent substance use disorder in the United States. However, the current literature on AUD as a preoperative risk factor for Total Shoulder Arthroplasty (TSA) outcomes is limited. The purpose of this study was to identify the association of AUD with revision rates and 90-day postoperative complications in TSA. METHODS: A retrospective study was conducted using the PearlDiver database. Patients diagnosed with AUD were identified. Patients in remission or with underlying cirrhosis were excluded. Outcomes included 2-year revision, 90-day readmission, 90-day emergency, and 90-day post-operative medical complications. Analysis was performed with univariate chi-squared tests followed by multivariable logistic regression. RESULTS: A total of 59,261 patients who underwent TSA for osteoarthritis were identified, with 1522 patients having a diagnosis of AUD. Multivariable logistic regression showed that patients with AUD were more likely to undergo 2-year all-cause revision (OR = 1.49,   =  0.007), 2-year aseptic revision (OR = 1.47,   =  0.014), 90-day hospital readmission (OR = 1.57,   =  0.015), and 90-day transient mental disorder (OR = 2.13,   =  0.026). CONCLUSIONS: AUD is associated with increased rates of 2-year revision surgery, as well as 90-day readmission and 90-day transient mental disorder following primary TSA for osteoarthritis. These findings may assist orthopedic surgeons in counseling patients with AUD during the pre-operative course.

Department

School of Medicine and Health Sciences Resident Works

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