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Discharge Destination After Shoulder Arthroplasty: An Independent Risk Factor for Readmission and Complications

Introduction: Postdischarge disposition after shoulder replacement lacks uniform guidelines. The goal of this study was to identify complication and readmission rates by discharge disposition and determine whether disposition was an independent risk factor for adverse events, using a statewide database. Methods: Data from the California Office of Statewide Health Planning and Development discharge database were used. Patient information was assessed, and 30- and 90-day complication rates were identified. Univariate and multivariate analyses were used to determine the complication risk. Results: From 2011 to 2013, 10,660 procedures were identified, with 7,709 patients discharged home, 1,858 discharged home with home health support, and 1,093 discharged to postacute care (PAC) facilities. Patients discharged to PAC facilities or to home with health support tended to be older, female, and using Medicare. After controlling for confounders, at 30 and 90 days, patients discharged to PAC facilities were found to be more likely to experience a complication. Discussion: Discharge to a PAC facility was an independent risk factor for complications and readmission. Level of Evidence: Level III, retrospective cohort design, observational study.