Frailty is Associated with Increased Complication, Readmission, and Hospitalization Costs Following Primary Total Shoulder Arthroplasty

Frailty is an age-related state of multi-system decline that has been associated with negative outcomes after surgery. Numerous methods have been utilized to quantify frailty and predict postoperative outcomes with variable results. The purpose of this study is to determine if the Hospital Frailty Risk Score (HFRS) is an independent predictor of postoperative complications and increased healthcare costs following elective primary total shoulder arthroplasty (TSA). The Nationwide Readmissions Database was queried to select patients undergoing elective primary TSA from 2016-2020. HFRS was calculated for each patient and patients with scores of five or greater were considered frail. Demographic characteristics, preoperative comorbidities, postoperative complications, and healthcare resource utilization metrics were compared between frail and non-frail patients using bivariate analysis. Binary logistic regression was used to determine if HFRS was independently predictive of adverse postoperative outcomes. There were 44,118 frail patients and 210,032 control patients undergoing TSA included in this study. After logistic regression analysis, HFRS was shown to be independently predictive of any complication (p