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  1. Article ; Online: Disparities in postoperative total shoulder arthroplasty outcomes between Black and White patients.

    Ling, Kenny / Leatherwood, William / Fassler, Richelle / Burgan, Jane / Komatsu, David E / Wang, Edward D

    JSES international

    2023  Volume 7, Issue 5, Page(s) 842–847

    Abstract: Background: Despite the rise in surgical volume for total shoulder arthroplasty (TSA) procedures, racial disparities exist in outcomes between White and Black populations. The purpose of this study was to compare 30-day postoperative complication rates ... ...

    Abstract Background: Despite the rise in surgical volume for total shoulder arthroplasty (TSA) procedures, racial disparities exist in outcomes between White and Black populations. The purpose of this study was to compare 30-day postoperative complication rates between Black and White patients following TSA.
    Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried for all patients who underwent TSA between 2015 and 2019. Patient demographics and comorbidities were compared between cohorts using bivariate analysis. Multivariate logistic regression, adjusted for all significantly associated patient demographics and comorbidities, was used to identify associations between Black or African American race and postoperative complications.
    Results: A total of 19,733 patients were included in the analysis, 18,669 (94.6%) patients in the White cohort and 1064 (5.4%) patients in the Black or African American cohort. Demographics and comorbidities that were significantly associated with Black or African American race were age 40-64 years (
    Conclusion: Black or African American race was independently associated with higher rates of 30-day readmission following TSA.
    Language English
    Publishing date 2023-05-26
    Publishing country United States
    Document type Journal Article
    ISSN 2666-6383
    ISSN (online) 2666-6383
    DOI 10.1016/j.jseint.2023.05.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Readmission and Reoperation Following Carpometacarpal Arthroplasty.

    Ling, Kenny / Fassler, Richelle / Burgan, Jane / Komatsu, David E / Wang, Edward D

    Journal of hand surgery global online

    2023  Volume 5, Issue 5, Page(s) 661–666

    Abstract: Purpose: Carpometacarpal (CMC) arthroplasty is an effective surgical treatment for osteoarthritis of the CMC joint. Risk factors for readmission and reoperation have been studied for other joint arthroplasty procedures but have not yet been studied for ... ...

    Abstract Purpose: Carpometacarpal (CMC) arthroplasty is an effective surgical treatment for osteoarthritis of the CMC joint. Risk factors for readmission and reoperation have been studied for other joint arthroplasty procedures but have not yet been studied for CMC arthroplasty. The purpose of this study was to identify patient demographics and comorbidities associated with 30-day readmission and 30-day reoperation after CMC arthroplasty.
    Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all records of patients who underwent CMC arthroplasty between 2015 and 2020. Variables collected in this study included patient demographics, comorbidities, surgical characteristics, and 30-day postsurgical complication data. Multivariate logistic regression was used to identify independent associations between patient characteristics and readmission and reoperation after CMC arthroplasty.
    Results: In total, 6,432 records were included in this study: 34 (0.5%) were readmitted within 30 days, and 27 (0.4%) underwent reoperation within 30 days. Compared with the non-readmission cohort, the readmission cohort was significantly associated with higher rates of age ≥ 75 years (
    Conclusion: The clinically significant predictors for 30-day readmission and 30-reoperation after CMC arthroplasty were age ≥ 75 years, BMI ≥ 40 kg/m
    Type of study/level of evidence: Prognostic III.
    Language English
    Publishing date 2023-07-27
    Publishing country United States
    Document type Journal Article
    ISSN 2589-5141
    ISSN (online) 2589-5141
    DOI 10.1016/j.jhsg.2023.06.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Components of metabolic syndrome as significant risk factors for postoperative complications following total shoulder arthroplasty: hypertension, diabetes, and obesity.

    Fassler, Richelle / Ling, Kenny / Burgan, Jane / Komatsu, David E / Wang, Edward D

    JSES international

    2023  Volume 8, Issue 1, Page(s) 141–146

    Abstract: Background: Metabolic syndrome (MetS) is a known risk factor for adverse postoperative outcomes. However, the literature surrounding the effects of MetS on orthopedic surgery outcomes following total shoulder arthroplasty (TSA) remains understudied. The ...

    Abstract Background: Metabolic syndrome (MetS) is a known risk factor for adverse postoperative outcomes. However, the literature surrounding the effects of MetS on orthopedic surgery outcomes following total shoulder arthroplasty (TSA) remains understudied. The purpose of this study is to investigate the effect of MetS on postoperative 30-day adverse outcomes following TSA.
    Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent TSA between 2015 and 2020. After exclusion criteria, patients were divided into MetS and no MetS cohorts. MetS patients were defined as presence of hypertension, diabetes, and body mass index > 30 kg/m
    Results: A total of 26,613 patients remained after exclusion criteria, with 23,717 (89.1%) in the no MetS cohort and 2896 (10.9%) in the MetS cohort. On multivariate analysis, MetS was found to be an independent predictor of postoperative pneumonia (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.02-2.55;
    Conclusion: MetS was identified as an independent risk factor for postoperative pneumonia, renal insufficiency, acute renal failure, myocardial infarction, nonhome discharge, and prolonged hospital stay following TSA. These findings encourage physicians to medically optimize MetS patients prior to surgery to limit adverse outcomes.
    Language English
    Publishing date 2023-09-22
    Publishing country United States
    Document type Journal Article
    ISSN 2666-6383
    ISSN (online) 2666-6383
    DOI 10.1016/j.jseint.2023.08.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Risk factors for postoperative transfusion in diabetic patients following total shoulder arthroplasty.

    Fassler, Richelle / Ling, Kenny / Burgan, Jane / Tantone, Ryan / Komatsu, David E / Wang, Edward D

    JSES international

    2023  Volume 7, Issue 6, Page(s) 2454–2460

    Abstract: Background: Diabetes has been reported as a risk factor for postoperative transfusion following total shoulder arthroplasty (TSA). However, the risk factors specific to diabetic patients that increase their likelihood of postoperative blood transfusion ... ...

    Abstract Background: Diabetes has been reported as a risk factor for postoperative transfusion following total shoulder arthroplasty (TSA). However, the risk factors specific to diabetic patients that increase their likelihood of postoperative blood transfusion remains understudied. The purpose of the study was to investigate the risk factors that are associated with 30-day postoperative transfusion among diabetic patients who undergo TSA.
    Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent TSA between 2015 and 2020. Both patients with and without diabetes were divided into cohorts based on 30-day postoperative transfusion requirement. Bivariate logistic regression was used to compare patient demographics and comorbidities. Multivariate logistic regression, adjusted for all significant patient demographics and comorbidities, was used to identify the characteristics independently associated with postoperative transfusion.
    Results: A total of 4376 diabetic patients remained after exclusion criteria, with 4264 (97.4%) patients who did not require postoperative transfusion and 112 (2.6%) patients who did require postoperative transfusion. On multivariate analysis, female gender (odds ratio [OR] 2.43, 95% confidence interval [CI] 1.52-3.89;
    Conclusion: Female gender, American Society of Anesthesiologists ≥3, bleeding disorder, transfusion prior to surgery, preoperative anemia, and operative duration ≥129 minutes were independently associated with postoperative transfusion following TSA in diabetic patients. These findings encourage physicians to carefully assess patients with diabetes preoperatively to minimize adverse outcomes.
    Language English
    Publishing date 2023-07-24
    Publishing country United States
    Document type Journal Article
    ISSN 2666-6383
    ISSN (online) 2666-6383
    DOI 10.1016/j.jseint.2023.06.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Aspartate Aminotransferase-to-Platelet Ratio Index Suggestive of Liver Dysfunction Predicts Early Complications After Open Reduction Internal Fixation of Distal Radius Fractures.

    Liu, Steven H / Burgan, Jane / Ling, Kenny / Loyst, Rachel A / Tantone, Ryan / Komatsu, David E / Wang, Edward D

    Journal of hand surgery global online

    2023  Volume 6, Issue 1, Page(s) 1–5

    Abstract: Purpose: Aspartate aminotransferase-to-platelet ratio index (APRI) is a cost-effective and noninvasive measure of liver function, an alternative to the gold standard liver biopsy, which is resource-intensive and invasive. The purpose of this study was ... ...

    Abstract Purpose: Aspartate aminotransferase-to-platelet ratio index (APRI) is a cost-effective and noninvasive measure of liver function, an alternative to the gold standard liver biopsy, which is resource-intensive and invasive. The purpose of this study was to investigate the association between preoperative APRI and 30-day postoperative complications after isolated open reduction internal fixation (ORIF) of distal radius fractures (DRFs).
    Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent isolated ORIF of DRFs between 2015 and 2021. The study population was divided into two groups on the basis of preoperative APRI: normal/reference (APRI, <0.5) and liver dysfunction (APRI, ≥0.5). Information on patient demographics, comorbidities, and 30-day postoperative complications after isolated ORIF of DRFs was collected. Multivariate logistic regression analysis was performed to investigate the relationship between preoperative APRI and postoperative complications.
    Results: Compared to patients with normal APRI, patients with preoperative APRI associated with liver dysfunction were significant for male sex (
    Conclusions: Aspartate aminotransferase-to-platelet ratio index values associated with liver dysfunction were associated with an increased rate of early postoperative complications after DRF ORIF.
    Clinical relevance: This study suggests APRI's utility as a cost-effective, noninvasive measure of liver function that physicians can use before surgery to better identify surgical candidates with DRFs and suspicion of liver dysfunction.
    Type of study/level of evidence: Prognostic III.
    Language English
    Publishing date 2023-10-17
    Publishing country United States
    Document type Journal Article
    ISSN 2589-5141
    ISSN (online) 2589-5141
    DOI 10.1016/j.jhsg.2023.06.016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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