BACKGROUND: The primary aim was to quantify the 30-day, 90-day, and 1-year mortality rates after primary shoulder replacement. The secondary aims were to assess the association between mortality and diagnoses and to compare the mortality rate with that of the general population.

METHODS: The study included 5853 primary operations reported to the Danish Shoulder Arthroplasty Registry between 2006 and 2012. Information about deaths was obtained from the Danish Cause of Death Register and the Danish Civil Registration System. Age- and sex-adjusted control groups were retrieved from Statistics Denmark.

RESULTS: The mean age was 69.3 ± 11.6 years, and 69.2% of patients were women. Of the patients, 39 (0.7%) died within 30 days, 88 (1.5%) within 90 days, and 222 (3.8%) within 1 year. Fracture patients had an incidence rate of 1256 per 100,000 within 30 days, which was significantly higher than the incidence rate of 182 per 100,000 in the general population (P < .001), whereas osteoarthritis patients had an incidence of 111 per 100,000, which was significantly lower than the incidence rate of 125 per 100,000 in the general population.

CONCLUSIONS: Fracture patients had a 6 times higher incidence of death within 30 days than the general population. However, the difference was equalized during the first year. This finding indicates that the injury and arthroplasty procedure are associated with an increased risk of death for these patients. Pulmonary, cardiac, and abdominal causes of death were common, and for fracture patients in particular, close postoperative monitoring of pulmonary, cardiac, and abdominal conditions seems important.