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

Background: The purpose of this study is to examine the effect of hypoalbuminemia (HA) on sentinel adverse eventsafter total shoulder arthroplasty (TSA).Methods: Patients who underwent primary TSA from ۲۰۱۵-۲۰۱۸ were collected from the National Surgical QualityImprovement Program (NSQIP) database. Patients with HA (serum albumin < ۳.۵ g/dL) were compared to patients withnormal serum albumin. A probit regression model was used to estimate a propensity score. Logistic regression wasperformed to evaluate the effect of HA on sentinel adverse events after surgery.Results: A total of ۴,۳۳۷ patients were included, ۸.۲% of patients had HA. Patients with HA had higher rates ofsentinel adverse events (۱۴.۰% vs ۵.۵%, P<۰.۰۱) compared with patients who had normal serum albumin. Reoperation(۴.۵% vs ۱.۵%, P<۰.۰۱), readmission (۱۱.۲% vs ۳.۹%, P<۰.۰۱), urinary tract infection (۰.۸% vs ۰.۰۳%, P<۰.۰۱) andpulmonary embolism (۱.۱% vs ۰.۲%, P=۰.۰۱) were higher in patients with HA. The odds ratio for a sentinel event forpatients with HA was ۲.۶ (۹۵% CI: ۱.۵۴, ۴.۴۴, P<۰.۰۱) when compared to a propensity score-matched control group.Conclusion: Patients with HA are at increased risk of sentinel adverse events following TSA compared to patients withnormal serum albumin levels.Level of evidence: II

Keywords:

Adverse events , Albumin , Hypoalbuminemia , Shoulder Arthroplasty