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Gender Analysis of Rotator Cuff Repair Utilization and Outcomes

Gender Analysis of Rotator Cuff Repair Utilization and Outcomes

Samuel S Rudisill, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Jacob Linker, BA, UNITED STATES Sara Naessig, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Nathan J Cherian, MD, UNITED STATES Zachary Logan LaPorte, BA, UNITED STATES Matthew J Best, MD, UNITED STATES Scott D Martin, MD, UNITED STATES

Department of Orthopaedic Surgery, Massachusetts General Hospital / Harvard Medical School, Boston, MA, UNITED STATES


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Summary: Sex differences among patients undergoing arthroscopic rotator cuff repair are evident, indicating need for further research to understand and address root causes of inequality and optimize care for all.


Introduction

As the volume and proportion of patients treated arthroscopically for rotator cuff repair increases, it is important to recognize sex differences in utilization and outcomes.

Methods

Patients who underwent arthroscopic rotator cuff repair between 2010 and 2019 were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) registry. Baseline demographic and clinical characteristics were collected, and information concerning utilization, operative time, length of hospital stay, days from operation to discharge, readmission, and adverse events were analyzed by sex.

Results

Of 42,443 included patients, 57.7% were male and 42.3% were female. Comparably, females were generally older and less healthy as indicated by ASA class and rates of obesity (52.0% vs. 47.8%), COPD (4.0% vs. 2.7%), and steroid use (2.7% vs. 1.6%). Females experienced shorter operative times (mean difference [MD] 11.5 minutes), longer hospital stays (MD 0.03 days), longer times from operation to discharge (MD 0.03 days), and more minor adverse events (odds ratio [OR] 1.75) after baseline adjustment. Conversely, rates of serious adverse events (OR 0.69) and readmissions (OR 0.88) were lower amongst females. Disparities in utilization increased over the study period, whereas length of stay and adverse events remained stable.

Discussion And Conclusion

Sex differences among patients undergoing arthroscopic rotator cuff repair are evident, indicating need for further research to understand and address root causes of inequality and optimize care for all.

ACKNOWLEDGEMENTS: Conine Family Foundation for Joint Preservation


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