JSES reviews, reports, and techniques · 2026
Impact of area deprivation index on outcomes and health care utilization following shoulder arthroplasty: a systematic review.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Movassaghi Aghdas, Bhatti Humza, Sims Keith, Ramirez Cesar A, Caudle Krysta, Sperling John W, Marigi Erick M, Sanchez-Sotelo Joaquin
Аннотация
BACKGROUND: Socioeconomic factors play a critical role in shaping health care outcomes, yet their impact on surgical recovery and post-operative quality of life is often underexplored. The Area Deprivation Index (ADI) is a validated metric used to quantify socioeconomic disadvantage, providing insight into disparities in health care access and outcomes. Despite its relevance, the extent of ADI score reporting in the context of shoulder arthroplasty (SA) remains unclear. This systematic review assesses the extent to which ADI has been incorporated into SA studies and examines its association with post-operative outcomes and health care utilization.
METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant search of PubMed, Scopus, and Embase was conducted using the keywords "area deprivation index," "shoulder arthroplasty," and "outcomes." Eligible studies, published in English within the past 10 years, included randomized controlled trials and cohort studies reporting ADI or related socioeconomic metrics in SA populations, focusing on post-operative outcomes, complications, health care utilization, and readmissions. We excluded studies that did not involve SA or failed to report ADI. In addition, case reports, reviews, editorials, conference abstracts, and non-English publications were excluded.
RESULTS: Eight studies met the inclusion criteria, comprising 264,287 patients. Socioeconomic disadvantage, as measured by the ADI, was associated with lower pre-operative and post-operative functional scores, with 2 studies reporting significantly worse ASES scores in the most disadvantaged groups (P < .01). Readmission rates showed mixed findings; one study found higher odds of readmission in the most disadvantaged group (odds ratio = 1.56, P = .001), while others reported no significant association. Two studies identified a modest but significant increase in post-operative complications among disadvantaged patients (odds ratio range: 1.1-1.13, P < .005). Heterogeneity in ADI stratification and outcome reporting limited quantitative synthesis.
CONCLUSION: Socioeconomic disadvantage, as measured by the ADI, is associated with worse functional outcomes following shoulder arthroplasty. Patients from the most disadvantaged neighborhoods had lower pre-operative and post-operative patient-reported outcome measures, while findings on readmissions and complications were not consistent amongst studies. Integrating ADI into clinical decision-making may help identify at-risk patients and reduce disparities in SA outcomes.
METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant search of PubMed, Scopus, and Embase was conducted using the keywords "area deprivation index," "shoulder arthroplasty," and "outcomes." Eligible studies, published in English within the past 10 years, included randomized controlled trials and cohort studies reporting ADI or related socioeconomic metrics in SA populations, focusing on post-operative outcomes, complications, health care utilization, and readmissions. We excluded studies that did not involve SA or failed to report ADI. In addition, case reports, reviews, editorials, conference abstracts, and non-English publications were excluded.
RESULTS: Eight studies met the inclusion criteria, comprising 264,287 patients. Socioeconomic disadvantage, as measured by the ADI, was associated with lower pre-operative and post-operative functional scores, with 2 studies reporting significantly worse ASES scores in the most disadvantaged groups (P < .01). Readmission rates showed mixed findings; one study found higher odds of readmission in the most disadvantaged group (odds ratio = 1.56, P = .001), while others reported no significant association. Two studies identified a modest but significant increase in post-operative complications among disadvantaged patients (odds ratio range: 1.1-1.13, P < .005). Heterogeneity in ADI stratification and outcome reporting limited quantitative synthesis.
CONCLUSION: Socioeconomic disadvantage, as measured by the ADI, is associated with worse functional outcomes following shoulder arthroplasty. Patients from the most disadvantaged neighborhoods had lower pre-operative and post-operative patient-reported outcome measures, while findings on readmissions and complications were not consistent amongst studies. Integrating ADI into clinical decision-making may help identify at-risk patients and reduce disparities in SA outcomes.