Saturday, April 3, 2021

Total shoulder risk is increased with increasing severity of anemia

 Increasing Severity of Anemia Is Associated with Poorer 30-Day Outcomes for Total Shoulder Arthroplasty

These authors conducted a retrospective analysis of the American College of Surgeons National Surgery Quality Improvement Project to identify all primary total shoulder arthroplasty procedures recorded in the 2015- 2018 timeframe.   

11,404 patients had greater than 38% preoperative hematocrit (HCT) and were classified as having normal HCT levels. 

2962 patients had HCT values between 33-38% and were classified as having mild anemia. 

819 patients had less than 33% HCT and were classified as having moderate/severe anemia.

The relationship between preoperative HCT and outcomes is shown in the chart below.

Multivariate analysis identified anemia as an independent predictor of readmissions, reoperations, minor complications, and major complications. Complications included postoperative myocardial infarction, cardiac arrest, unplanned reintubation, prolonged use of ventilators, increased rates of pneumonia and increased rates of urinary tract infection.

Comment: This study echoes the findings in previous publications (see this link). It is not known whether preoperative treatment designed to address anemia is effective in reducing the rates of complications.

Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).