CHARLSON COMORBIDITY INDEX

Aprofitant el article anterior descobreixo el index de Charlson per mesurar comorbilitats i poder comparar edad amb comorbilitats... De pas un excel que ajuda a calcular-ho.

Aqui el paragraf en que es fa esmena :

General patient health at index surgery was measured using the Charlson Comorbidity Index (CCI). The CCI is a validated measure of burden of disease. Comorbidities are weighted from 1 to 6 for mortality risk and disease severity and then summed to form the total CCI score. Complication rates were stratified by CCI scores to analyze the association between base- line comorbidity burden and surgical complications after shoulder arthroplasty.  Rates of complications, admission for a surgical complication, and revisions were calculated for each surgical group and for combinations of surgical group and comorbidity score.

TAXA COMPLICACIONS PROTESI ESPATLLA

Shoulder arthroplasty in the US Medicare population: a 1-year evaluation of surgical complications, hospital admissions, and revision surgery

S.B. Floyd et al. / JSES Open Access 2 (2018) 40–47

Background: The objective of this study was to describe patients receiving each shoulder arthroplasty procedure and to assess surgical complications, hospital admissions for surgical complications, and surgical revisions among Medicare beneficiaries undergoing shoulder arthroplasty.

Methods: Medicare patients receiving shoulder arthroplasty in the United States in 2011 were identi- fied from Medicare administrative data and classified by surgery type: 
1.- shoulder hemiarthroplasty (HA)
2.- anatomic total shoulder arthroplasty (TSA)
3.- reverse shoulder arthroplasty (RSA). 
Surgical complications, hospital admissions, and revisions were identified during the year after the index arthroplasty procedure.

Results: Therewere 24,441 patients who met all inclusion criteria.
20.0% received HA, 
42.5% - TSA, 
37.4% - RSA. 
Compared with RSA and TSA recipients, HA recipients tended to be older and sicker and were more likely to be Medicaid eligible. The rate of new surgical complications and related hospital admissions was greatest during the first 50 days after surgery but remained significant and stable throughout the remainder of the year. 

Rates of complications and related hospital admissions were greatest for HA recipients 
HA (17.4% and 6.6%, respectively),
RSA (14.2% and 5.1%) 
TSA (9.4% and 4.0%).

Conclusions: The rate of adverse surgical outcomes after shoulder arthroplasty differed across popu- lations that received HA, TSA, and RSA and across patients within each group by comorbidity burden. The finding that the rate of surgical complications and related hospital admissions remained meaningful during the entire year after surgery suggests that a postoperative follow-up period longer than the traditional 90 days may be warranted.

Pot ser que l'alta incidència de revisions de les hemi sigui un altre factor mes que ha fet augmentar la indicació d'una Inversa?. "Si non e vero ....