USF-LVHN SELECT
Social Determinants of Health Disparities Are Associated With Increased Costs, Revisions, and Infection in Patients Undergoing Arthroscopic Rotator Cuff Repair.
Publication/Presentation Date
3-1-2023
Abstract
PURPOSE: The purpose of this study was to use a national claims database to assess the impact of pre-existing social determinants of health disparities (SDHD) on postoperative outcomes following rotator cuff repair (RCR).
METHODS: A retrospective review of the Mariner Claims Database was used to capture patients undergoing primary RCR with at least 1 year of follow-up. These patients were divided into two cohorts based on the presence of a current or previous history of SDHD, encompassing educational, environmental, social, or economic disparities. Records were queried for 90-day postoperative complications, consisting of minor and major medical complications, emergency department (ED) visits, readmission, stiffness, and 1-year ipsilateral revision surgery. Multivariate logistic regression was employed to assess the impact of SDHD on the assessed postoperative outcomes following RCR.
RESULTS: 58,748 patients undergoing primary RCR with a SDHD diagnosis and 58,748 patients in the matched control group were included. A previous diagnosis of SDHD was associated with an increased risk of ED visits (OR 1.22, 95% CI 1.18-1.27; P < .001), postoperative stiffness (OR 2.53, 95% CI 2.42-2.64; P < .001), and revision surgery (OR 2.35, 95% CI 2.13-2.59; P < .001) compared to the matched control group. Subgroup analysis revealed educational disparities had the greatest risk for 1-year revision (OR 3.13, 95% CI 2.53-4.05; P < .001).
CONCLUSIONS: The presence of a SDHD was associated with an increased risk of revision surgery, postoperative stiffness, emergency room visits, medical complications, and surgical costs following arthroscopic RCR. Overall, economic and educational SDHD were associated with the greatest risk of 1-year revision surgery.
LEVEL OF EVIDENCE: III, retrospective cohort study.
Volume
39
Issue
3
First Page
673
Last Page
679
ISSN
1526-3231
Published In/Presented At
Raso, J., Kamalapathy, P., Cuthbert, A. S., Althoff, A., Ramamurti, P., & Werner, B. C. (2023). Social Determinants of Health Disparities Are Associated With Increased Costs, Revisions, and Infection in Patients Undergoing Arthroscopic Rotator Cuff Repair. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 39(3), 673–679.e4. https://doi.org/10.1016/j.arthro.2022.10.011
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
37194108
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article