Document Type : RESEARCH PAPER
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD
Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD
Object: The purpose of this study is to examine the effect of hypoalbuminemia on sentinel adverse events after total shoulder arthroplasty.
Methods: Patients who underwent primary total shoulder arthroplasty from 2015-2018 were collected from the National Surgical Quality Improvement Program (NSQIP) database. Patients with hypoalbuminemia (serum albumin < 3.5 g/dL) were compared to patients with normal serum albumin. A probit regression model was used to estimate a propensity score. Logistic regression was performed to evaluate the effect of hypoalbuminemia on sentinel adverse events after surgery.
Results: A total of 4,337 patients were included; 8.2% of patients had hypoalbuminemia. Patients with hypoalbuminemia had higher rates of sentinel adverse events (14.0% vs 5.5%, p<0.01) compared with patients who had normal serum albumin. Reoperation (4.5% vs 1.5%, p<0.01), readmission (11.2% vs 3.9%, p<0.01), urinary tract infection (0.8% vs 0.03%, p<0.01) and pulmonary embolism (1.1% vs 0.2%, p=0.01) were higher in patients with hypoalbuminemia. The OR for a sentinel event for patients with hypoalbuminemia was 2.6 (95% CI: 1.54, 4.44; p<0.01) when compared to a propensity score matched control group.
Conclusion: Patients with hypoalbuminemia are at increased risk of sentinel adverse events following total shoulder arthroplasty compared to patients with normal serum albumin levels.