Lu Y, Khazi ZM, Patel BH, Agarwalla A, Cancienne J, Werner BC, Forsythe B. Big Data in Total Shoulder Arthroplasty: An In-depth Comparison of National Outcomes Databases.
J Am Acad Orthop Surg 2020;
28:e626-e632. [PMID:
32692100 DOI:
10.5435/jaaos-d-19-00173]
[Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION
The practice of identifying trends in surgical decision-making through large-scale patient databases is commonplace. We hypothesize that notable differences exist between claims-based and prospectively collected clinical registries.
METHODS
We queried the American College of Surgeons National Surgical Quality Improvement Program (NSQIP), a prospective surgical outcomes database, and PearlDiver (PD), a claims-based private insurance database, for patients undergoing primary total shoulder arthroplasties from 2007 to 2016. Comorbidities and 30-day complications were compared. Multiple regression analysis was performed for each cohort to identify notable contributors to 30-day revision surgery.
RESULTS
Significant differences were observed in demographics, comorbidities, and postoperative complications for the age-matched groups between PD and NSQIP (P < 0.05 for all). Multiple regression analysis in PD identified morbid obesity and dyspnea to lead to an increased risk for revision surgery (P = 0.001) in the <65 cohort and dyspnea and diabetes to lead to an increased risk for revision surgery in the ≥65 cohort (P = 0.015, P < 0.001). Multiple regression did not reveal any risk factors for revision surgery in the <65 age group for the NSQIP; however, congestive heart failure was found to have an increased risk for revision surgery in the ≥65 cohort (P < 0.001).
CONCLUSIONS
Notable differences in comorbidities and complications for patients undergoing primary total shoulder arthroplasty were present between PD and NSQIP.
LEVEL OF EVIDENCE
Retrospective cohort study, level III.
Collapse