A Point-Based Model to Predict Absolute Risk of Revision in Anatomic Shoulder Arthroplasty.
competing risk
revision
risk prediction
shoulder arthroplasty
shoulder hemiarthroplasty
Journal
Journal of shoulder and elbow arthroplasty
ISSN: 2471-5492
Titre abrégé: J Shoulder Elb Arthroplast
Pays: United States
ID NLM: 101763114
Informations de publication
Date de publication:
2019
2019
Historique:
received:
22
04
2019
revised:
31
08
2019
accepted:
29
09
2019
entrez:
9
9
2021
pubmed:
21
10
2019
medline:
21
10
2019
Statut:
epublish
Résumé
Total shoulder arthroplasty (TSA) has demonstrated good long-term survivorship but early implant failure can occur. This study identified factors associated with shoulder arthroplasty revision and constructed a risk score for revision surgery following shoulder arthroplasty. A validated algorithm was used to identify all patients who underwent anatomic TSA between 2002 and 2012 using population-based data. Demographic variables included shoulder implant type, age and sex, Charlson comorbidity score, income quintile, diagnosis, and surgeon arthroplasty volume. The associations of covariates with time to revision were measured while treating death as a competing risk and were expressed in the Shoulder Arthroplasty Revision Risk Score (SARRS). During the study period, 4079 patients underwent TSA. Revision risk decreased in a nonlinear fashion as patients aged and in the absence of osteoarthritis with no influence from surgery type or other covariables. The SARRS ranged from -21 points (5-year revision risk 0.75%) to 30 points (risk 11.4%). Score discrimination was relatively weak 0.55 (95% confidence interval: 0.530.61) but calibration was very good with a test statistic of 5.77 ( The SARRS model accurately predicted the 5-year revision risk in patients undergoing TSA. Validation studies are required before this score can be used clinically to predict revision risk. Further study is needed to determine if the addition of detailed clinical data including functional outcome measures and the severity of glenohumeral arthrosis increases the model's discrimination.
Sections du résumé
BACKGROUND
BACKGROUND
Total shoulder arthroplasty (TSA) has demonstrated good long-term survivorship but early implant failure can occur. This study identified factors associated with shoulder arthroplasty revision and constructed a risk score for revision surgery following shoulder arthroplasty.
METHODS
METHODS
A validated algorithm was used to identify all patients who underwent anatomic TSA between 2002 and 2012 using population-based data. Demographic variables included shoulder implant type, age and sex, Charlson comorbidity score, income quintile, diagnosis, and surgeon arthroplasty volume. The associations of covariates with time to revision were measured while treating death as a competing risk and were expressed in the Shoulder Arthroplasty Revision Risk Score (SARRS).
RESULTS
RESULTS
During the study period, 4079 patients underwent TSA. Revision risk decreased in a nonlinear fashion as patients aged and in the absence of osteoarthritis with no influence from surgery type or other covariables. The SARRS ranged from -21 points (5-year revision risk 0.75%) to 30 points (risk 11.4%). Score discrimination was relatively weak 0.55 (95% confidence interval: 0.530.61) but calibration was very good with a test statistic of 5.77 (
DISCUSSION
CONCLUSIONS
The SARRS model accurately predicted the 5-year revision risk in patients undergoing TSA. Validation studies are required before this score can be used clinically to predict revision risk. Further study is needed to determine if the addition of detailed clinical data including functional outcome measures and the severity of glenohumeral arthrosis increases the model's discrimination.
Identifiants
pubmed: 34497957
doi: 10.1177/2471549219883446
pii: 10.1177_2471549219883446
pmc: PMC8282172
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2471549219883446Informations de copyright
© The Author(s) 2019.
Déclaration de conflit d'intérêts
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article
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