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ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Outcomes of ambulatory versus outpatient hospital-based surgical center shoulder arthroplasty: complications, readmissions, and charges.

Paul G Mastrokostas, Joshua Harounian, Ameer Tabbaa, Lucas Voyvodic, Andrew Horn, Mitchell K Ng, Ramin Sadeghpour, Afshin E Razi, Jack Choueka

Abstract readComparative Study
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In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Paul G MastrokostasDepartment of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, NY, USA. pmastrokostas06@gmail.com.
Joshua HarounianDepartment of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
Ameer TabbaaDepartment of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Lucas VoyvodicDepartment of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
Andrew HornDepartment of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Mitchell K NgDepartment of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Ramin SadeghpourDepartment of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Afshin E RaziDepartment of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Jack ChouekaDepartment of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe rising demand for primary total shoulder arthroplasty (TSA) has spurred interest in comparing the safety and cost-effectiveness of outpatient TSA in ambulatory surgical centers (ASCs) versus hospital-based centers (HSCs). This study evaluates ASCs and HSCs for medical complications, readmission rates, implant complications, and costs.

methodsThis retrospective cohort study used the PearlDiver Mariner Database to identify patients undergoing primary TSA in ASCs or HSCs, assessing medical complications, readmissions, implant issues, and costs. ASC patients were matched in a 1:5 ratio to HSC patients by age, sex, region, and Elixhauser Comorbidity Index (ECI). Logistic regression analyzed the impact of ASC versus HSC settings on complications and readmissions, while Welch's t-tests compared costs. Statistical significance was determined by a P value less than or equal to 0.05.

resultsASCs showed lower odds of pulmonary embolism (OR = 0.69; P = 0.04), total medical complications (OR = 0.89; P = 0.01), prosthetic joint dislocation (OR = 0.43; P = 0.05), and total implant-related complications (OR = 0.85; P = 0.03), but a higher 90-day readmission rate (OR = 1.22; P < 0.01). ASCs also offered significant cost savings on the day of surgery ($4600 vs. $11,100; P < 0.01) and for 90-day total costs ($6600 vs. $13,500; P < 0.01) compared to HSCs.

conclusionOutpatient primary TSA in ASCs offers comparable safety with substantially lower costs than HSCs. Despite higher readmission rates, ASCs represent a viable, cost-effective alternative.

Indexed as

Ambulatory Surgical ProceduresArthroplasty, Replacement, ShoulderPatient ReadmissionPostoperative ComplicationsAgedCost-Benefit AnalysisFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeAmbulatory surgeryChargesComplicationsOutpatientReadmissionShoulder arthroplasty

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.