Septuagenarians versus octogenarians in elective upper extremity procedures

Background With a rapidly aging American population, elective shoulder procedures are increasingly performed in older adults. Prior studies have largely focused on total shoulder arthroplasty, leaving limited data on outcomes across a broader range of elective shoulder procedures. This study aimed to compare postoperative outcomes between septuagenarians and octogenarians undergoing elective shoulder surgery. Methods The American College of Surgeons National Surgical Quality Improvement Program database (2011–2022) was queried for patients aged 70–89 years undergoing elective shoulder procedures, and patients were stratified into septuagenarians (70–79 years) and octogenarians (80–89 years). Multivariable logistic regression analyses adjusted for demographic and clinical covariates were used to assess postoperative outcomes. Results A total of 12,099 patients were included, comprising 10,810 septuagenarians (89%) and 1289 octogenarians (11%). After adjustment, octogenarians had higher odds of unplanned readmission (OR 1.57, 95% CI 1.04–2.29; p  = 0.026) and non-home discharge (OR 2.44, 95% CI 1.57–3.72; p  < 0.001). No significant differences were observed in overall complications, reoperation, or 30-day mortality. Discussion Octogenarians undergoing elective shoulder procedures are at increased risk for readmission and non-home discharge despite similar short-term complication rates. These findings underscore the importance of perioperative planning and discharge optimization in this population.