Document Type

Conference Proceeding

Publication Date

4-18-2026

Abstract

OBJECTIVE: Cost conservation and value are major components of orthopedic surgery and health economics. A frequent measure used to mitigate cost is the utilization of same day discharge (SDD) after total shoulder arthroplasty (TSA). The purpose of this study was to investigate if patient travel distance is associated with safe SDD. Secondarily, we aimed to identify other patient factors associated with safe SDD. Our hypothesis was that increased travel distance would be associated with decreased SDD. METHODS: This retrospective review included all patients undergoing primary anatomic or reverse total shoulder arthroplasty by at a single institution between January 2021 to June 2024 in a hospital setting. Patient demographic information, medical comorbidities, surgical factors, and distance in miles to the hospital were collected. Patients were placed into two groups: those discharged the same day as surgery, and those requiring ³ 1 night hospital stay. Outcomes collected included implant complications, 90-day emergency department utilization, and 90-day readmissions. RESULTS: After exclusion criteria, 691 patients were included in the study. 358 were SDD while 333 stayed ³ 1 night. There was no association between distance traveled and SDD. Patients who were admitted were older (73.12 v 69.14; p < 0.001), more frequently women (63.1% v 44.7%; p < 0.001), less likely to be independent ambulators (70.3 % v 82.4%; p < 0.001), and more likely to live alone (24.6% v 11.7%; p < 0.001). Patients admitted for ≥ 1 night stay were also more likely to have a higher ASA score, have history of diabetes mellitus, hypertension, coronary artery disease, and chronic kidney disease. Of all significant factors, age, female gender, level of assistance at home and ASA III remained significantly associated with hospital admission on multivariate testing. There was no difference between the two groups regarding implant complications, 90-day ED utilization or 90-day readmissions. CONCLUSION: The decision for SDD after total shoulder arthroplasty is multifactorial but is not associated with the distance travelled by the patient to the hospital. Increased age, female gender, use of cane for ambulation and ASA III are independently associated with need for hospital admission after total shoulder arthroplasty. Living with a spouse is independently associated with same day discharge.

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Mid-America Orthopaedic Association Annual Meeting, April 15-18, 2026, Point Clear, AL

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