Alexis A. Williams - Sidney Kimmel Medical College at Thomas Jefferson University, Department of Orthopaedics Surgery, Philadelphia, PA
Eric H. Tischler - The Rothman Institute, Thomas Jefferson University, ۹۲۵ Chestnut St. ۵th Floor, Philadelphia, PA
Daniel Sholder - The Rothman Institute, Thomas Jefferson University, ۹۲۵ Chestnut St. ۵th Floor, Philadelphia, PA
Thema A. Nicholson - The Rothman Institute, Thomas Jefferson University, ۹۲۵ Chestnut St. ۵th Floor, Philadelphia, PA

Purpose Purpose The purpose of this study was to determine patient-specific risk factors and clinical intervention rates for abnormal postoperative Chem-7 panels in shoulder arthroplasty patients. Methods Retrospectively, all primary anatomic total (aTSA) and reverse shoulder (RTSA) arthroplasties (between 2007-2013) performed at a single institution were identified. All patients underwent routine preoperative and postoperative day one (POD1) chemistry panels. Each clinically significant component of the Chem-7 panel was independently evaluated using a multivariate analysis to identify risk factors for abnormal results. Associated clinical intervention rates were also calculated. Results Data from 1,012 patients (248 RTSA; 764 aTSA) was analyzed. 5.4% of patients had at least one preoperative abnormal chemistry result. On multivariate analysis, patients with abnormal preoperative Chem-7 labs and a history of renal disease had significantly increased risk for abnormal POD1 labs (p <0.001). Although 25.6% (259/1,012) of patients had at least one abnormal POD1 lab result, the total postoperative clinical intervention rate was 15.1% (39/259). Conclusion Renal disease and a preoperative abnormal chemistry result are important risk factors for abnormal postoperative Chem-7. Optimizing renal status and correcting abnormal blood chemistry results preoperatively may reduce the incidence of abnormal postoperative chemistry results.

Blood chemistry, Laboratory order, Reverse shoulder arthroplasty, Risk stratification, Total Shoulder Arthroplasty