Comparison of 90-Day Medical Complications, Emergency Department Utilizations, and Readmissions for Corticosteroid Users Undergoing Hip Arthroscopy.

Abstract

Hip arthroscopy has increased in utilization with the improvement of surgical technique and technology. Although the rate of complications has historically been low, patient-specific factors may increase complication risk. The effects of preoperative corticosteroid use and resultant immunosuppression on outcomes following hip arthroscopy are not well understood. This study aimed to compare the rates and odds of 90-day medical complications, emergency department (ED) utilizations, and readmissions between corticosteroid users and nonusers undergoing hip arthroscopy. Using the PearlDiver nationwide claims database (2010 to 2021), corticosteroid users (N = 1,735) were propensity score matched in a 1:5 ratio to controls (N = 8,643) based on age, sex, and comorbidities, and Elixhauser comorbidity index. Ninety-day medical complications, ED utilization, and readmissions were compared. Logistic regression models were used to compute odds ratios (ORs) of medical complications, and 90-day ED visits and readmissions in corticosteroid users. Following Bonferroni correction, statistical significance was set at P < 0.01. Corticosteroid users demonstrated markedly higher odds of medical complications (OR, 4.75; P < 0.0001) compared with controls. Corticosteroid users had elevated rates and odds of deep vein thrombosis (1.27% vs. 0.25%; OR, 5.04; P < 0.0001), pneumonia (5.01% vs. 0.69%; OR, 7.81; P < 0.0001), blood transfusion (0.98% vs. 0.20%; OR, 5.06; P < 0.0001), surgical site infections (0.81% vs. 0.23%; OR, 3.51; P = 0.0003), and deep wound infections (0.69% vs. 0.22%; OR, 3.17; P = 0.001). Corticosteroid users had higher incidence and odds of ED visits (4.27% vs. 2.04%; OR, 2.15; P < 0.0001) and readmissions (4.84% vs. 2.07%; OR, 2.43; P < 0.0001) within 90 days. Corticosteroid users undergoing hip arthroscopy are at higher risk of 90-day medical complications, ED visits, and readmissions compared with noncorticosteroid users. These findings emphasize the need for careful perioperative planning and risk mitigation strategies for this high-risk group.