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.
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.
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