The impact of anemia on early postoperative complications in aseptic revision total shoulder arthroplasty

PMCID: PMC12177007

PMID: 40531329

DOI: 10.1007/s00590-025-04372-8

Journal: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

Publication Date: 2025-6-18

Authors: Liu SH, Leonardo CJ, Loyst RA, Konnayil BJ, Bramian A, et al.

Key Points

• Preoperative anemia is independently associated with increased 30-day postoperative complications in revision total shoulder arthroplasty
• Anemic patients had 8.71 times higher odds of requiring blood transfusions compared to non-anemic patients
• Preoperative hematocrit measurement can serve as a practical risk stratification tool for surgeons planning revision shoulder arthroplasty

Summary

This retrospective cohort study investigated the impact of preoperative anemia on 30-day postoperative complications in patients undergoing aseptic revision total shoulder arthroplasty (TSA). Using the American College of Surgeons National Surgical Quality Improvement Program database, researchers analyzed 2,080 patients from 2015 to 2022, stratifying them into normal and anemic groups based on gender-specific hematocrit thresholds.

The study revealed significant associations between preoperative anemia and adverse postoperative outcomes. Anemic patients experienced substantially higher rates of complications, with a multivariate analysis showing increased odds of any complication (OR 1.71, 95% CI 1.40–2.10), blood transfusions (OR 8.71, 95% CI 4.23–17.90), non-home discharge (OR 1.81, 95% CI 1.26–2.60), and prolonged hospital stay (OR 1.81, 95% CI 1.43–2.29). These findings highlight the critical importance of preoperative hematocrit assessment as a predictive marker for surgical risk in revision TSA.