Hypoalbuminemia and the Higher Risk of Perioperative Sentinel Adverse Events in Patients Undergoing Total Shoulder Arthroplasty: A Propensity Score Matched Analysis

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD

2 Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD

Abstract

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.

Keywords



Articles in Press, Accepted Manuscript
Available Online from 04 December 2021
  • Receive Date: 16 September 2021
  • Accept Date: 21 November 2021
  • First Publish Date: 04 December 2021