Epidemiology of shoulder instability in Italy: A 14-years nationwide registry study

• Published in: Injury Vol. 52; no. 4; pp. 862 - 868
• Main Authors: Longo, Umile Giuseppe, Candela, Vincenzo, Berton, Alessandra, Naro, Calogero Di, Migliorini, Filippo, Schena, Emiliano, Denaro, Vincenzo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2021
• Subjects: Arthroscopy; Bankart; Dislocation; Epidemiology; Shoulder; Arthroscopy; Epidemiology; Shoulder; Bankart; Dislocation
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2021.02.034

•Shoulder dislocations represent a very common problem in orthopaedic practice and common consequences are recurrence, pain, and inability to play sports. Surgical treatment is usually indicated in patients with chronic instability and history of repeated dislocations and primary surgical treatment remains a viable option in young physically active adults, in whom the risk of recurrence is high. Incidence of shoulder dislocation surgery is rapidly increasing.•The objectives of this study are: (1) to evaluate the number of hospitalizations for shoulder dislocations in Italy in the period from 2001 to 2014, analyzing the official hospitalization records; (2) to compare hospitalizations based on geographical variations considering three macro regions of Italy; (3) to perform statistical projections of the number of shoulder instability hospitalizations volumes and rates based on data from 2001 to 2014 by 2025.•Considering this study, increasing rates of surgical hospitalization and decreasing rates of hospitalization for non-surgical treatment of shoulder dislocation over a 14-year period are observed. Furthermore, the present study provides a description of the frequency and national distribution of shoulder instability in Italy and it demonstrates that there has been an outbreak of surgical procedures for shoulder instability in Italy. The aim of this study is to estimate the annual number of shoulder dislocation hospitalizations in Italy from 2001 to 2014, to explore geographical variation in access to hospitalizations between the 3 macro-regions of Italy (North, Centre and South) and to perform statistical projections of hospitalizations volumes and rates based on data from 2001 to 2014. Data of the Italian Ministry of Health regarding the National Hospital Discharge records (SDO) were analysed for the period of the survey (2001–2014). These data are anonymous and include the patient's age, sex, domicile, region of hospitalization, length of the hospitalization, and type of reimbursement (public or private). During the 14-year study period, 92,784 hospitalizations to treat shoulder dislocation were performed in Italy, which represented an incidence of 11.2 hospitalizations for every 100,000 Italian inhabitants. 56,514 patients underwent hospitalization for non-surgical treatment. 36,270 patients underwent hospitalization for surgical treatment. The higher hospitalizations rate was among males from 15 to 64 years of age. Increasing rates of surgical hospitalization and decreasing rates of hospitalization for non-surgical treatment of shoulder dislocation are observed over a 14-year period. This study confirms that the socioeconomic burden of shoulder dislocation surgery heavily affects the working population. Most shoulder instability procedures were performed on males. The present study provides a description of the frequency and national distribution of shoulder instability in Italy. This study shows an increase in surgical procedures for shoulder instability in Italy.