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.