Lower socioeconomic status was correlated with poorer outcomes in patients with glenohumeral osteoarthritis (OA) in a new study.
“Numerous studies have identified differences in patient-reported outcome scores and complication rates based on various measures of socioeconomic status (SES); however, there is limited information regarding the role of SES in the shoulder arthroplasty cohort. The purpose of this study was to characterize the role of SES in patients undergoing primary anatomic total shoulder arthroplasty (TSA) for primary glenohumeral osteoarthritis (OA),” the study authors wrote, publishing their findings in the April 1 issue of the Journal of the AAOS.
A total of 1,045 primary TSA patients treated for OA were identified in a prospective shoulder arthroplasty registry; 982 patients were eligible for study inclusion. Patient demographics, comorbidities, patient-reported outcome scores, range of motion, and preoperative opioid use data were collected. Patients were stratified by quartile per the Area Deprivation Index with their home address as a socioeconomic status measure.
Patients with the lowest socioeconomic status had a higher body mass index and higher rates of preoperative opioid use and diabetes. The most disadvantaged patients had greater levels of preoperative pain (Constant—Pain and American Shoulder and Elbow Surgeons [ASES]—Pain) and lower function (Constant—Activities of Daily Living, Constant—Total, and ASES). Upon multivariate regression, factors associated with better ASES pain scores were male sex and older age at surgery, while factors predictive of worse ASES pain scores were preoperative opioid use, chronic back pain, and being in the most disadvantaged quartile.
“Lower SES correlates with worse preoperative function and pain in patients undergoing anatomic TSA for primary glenohumeral OA. Providers should be cognizant of the potential impact of SES when evaluating quality metrics for patients with primary glenohumeral OA,” the researchers summarized.