Predicting Discharge Disposition After Shoulder Arthroplasty in the United States

Introduction: Postdischarge management for shoulder replacement continues to be performed on a case-by-case basis, with no uniform guidelines dictating management. The goal of this study was to develop a nomogram to preoperatively predict a patient's discharge disposition after elective shoulder arthroplasty. Methods: Patients who underwent elective shoulder arthroplasty between 2012 and 2015 were identified in the National Surgical Quality Improvement Program database. A multivariable logistic regression model was used to identify risk factors for discharge to a postacute care facility, and these results were used to create a predictive nomogram. Results: From 2012 to 2015, 8,363 procedures were identified. In our cohort, 962 patients (11.5%) were discharged to a postacute care facility, and 7,492 patients (88.5%) were discharged home. Preoperative functional status, followed by American Society of Anesthesiologists Class and age, had the strongest predictive value for discharge disposition after shoulder arthroplasty. Discussion: Discharge disposition can be predicted using a nomogram with commonly identified preoperative and intraoperative variables. Level of Evidence: Level III, retrospective cohort design, observational study