Noticewala MS, et al. - This study entailed an analysis of patients who underwent elbow arthroscopy, to determine the incidence and type of complications after elbow arthroscopy, the incidence of returning to the operating room (OR) after elbow arthroscopy, and patient and risk factors for complications across a national surgical outcome database. Findings reported low incidence of 30-day postoperative adverse events (1.89%) and a low need to return to the OR (0.94%). Researchers identified increased American Society of Anesthesiologists (ASA) class as an independent risk factor for the occurrence of a postoperative adverse event. The need to return to the OR was predicted by preoperative steroid use and diagnoses associated with a traumatic or inflammatory cause. This work provides information that can help surgeons in patient selection, preoperative optimization, and preoperative risk stratification.

Methods

• Researchers used Current Procedural Terminology codes to identify patients who underwent elbow arthroscopy from January 2005 through December 2014 in the American College of Surgeons National Surgical Quality Improvement Program database.
• They recorded basic patient demographic data and medical comorbidities.
• They also identified postoperative adverse events and a return to the OR occurring within 30 days after the index procedure, and investigated patient and procedural risk factors.

Results

• For analysis, a total of 530 elbow arthroscopy cases were available.
• Data demonstrated that the aggregate rate of 30-day adverse events was 2.83%, whereas the rate of any patient having an adverse event was 1.89%.
• Deep infection (0.57%) was reported as the most common adverse event.
• The association of renal disease, preoperative steroid use, higher American Society of Anesthesiologists (ASA) class, and preoperative diagnosis with the occurrence of an adverse event was highlighted in univariate analyses.
• Multivariate analyses demonstrated that a postoperative adverse event was independently predicted by increasing ASA class, specifically ASA class 3 and class 4.
• Furthermore, researchers found that 0.94% of cases needed a return to the OR.
• Association of preoperative steroid use and diagnosis of trauma with a return to the OR was shown in univariate analyses.
• Notably, these findings were corroborated by multivariate analyses.