ArticleJSES international2021
Increasing severity of anemia is associated with poorer 30-day outcomes for total shoulder arthroplasty.
Article in JSES international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Modifiable pre-operative physiological predictors of length of stay following shoulder arthroplasty: a systematic review.JSES reviews, reports, and techniques · 2026Review
- The impact of anemia on early postoperative complications in aseptic revision total shoulder arthroplasty.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Associations of preoperative hematocrit and platelet count with morbidity after pathologic fracture fixation.Journal of bone oncology · 2025Article
- Simultaneous bilateral reverse total shoulder arthroplasty for bilateral seizure-induced posterior shoulder fracture-dislocation complicated by severe postoperative anemia and hemorrhagic shock: a case report.JSES reviews, reports, and techniques · 2024Article
- Preoperative factors predict prolonged length of stay, serious adverse complications, and readmission following operative intervention of proximal humerus fractures: a machine learning analysis of a national database.JSES international · 2024Article
- Worsening of anemia increases the risks of complications and prolonged length of stay following revision total shoulder arthroplasty.Shoulder & elbow · 2024Article
- The geriatric nutritional risk index as a strong predictor of adverse outcomes following total shoulder arthroplasty.JSES international · 2024Article
- Anemia Severity and the Risks of Postoperative Complications and Extended Length of Stay Following Primary Total Elbow Arthroplasty.Hand (New York, N.Y.) · 2023Article
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Authors and funding
7 authors at 2 institutions in 1 country.
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Abstract
backgroundTotal shoulder arthroplasty (TSA) has increased in utilization over the past several decades. Anemia is a common preoperative condition among patients undergoing TSA and has been associated with poorer outcomes in other surgical procedures. To the best of our knowledge, no study has analyzed the association between anemia severity and TSA outcomes. Therefore, the purpose of this study is to determine the effects that increasing severity of anemia may have on the postoperative outcomes in patients receiving primary TSA.
methodsA retrospective analysis was performed using the American College of Surgeons National Surgery Quality Improvement Project database from the years 2015 to 2018. Current Procedure Terminology code 23472 was used to identify all primary TSA procedures recorded during this time frame. Patients with greater than 38% preoperative hematocrit (HCT) were classified as having normal HCT levels. Patients with HCT values between 33% and 38% were classified as having mild anemia. All patients with less than 33% HCT were classified as having moderate/severe anemia. Patient demographic information, preoperative risk factors, and postoperative outcomes were compared among the 3 cohorts. A multivariate logistic regression including demographic factors and comorbidities was performed to determine whether increasing severity of anemia is independently associated with poorer postoperative outcomes.
resultsOf the 15,185 patients included in this study, 11,404 had normal HCT levels, 2962 patients were mildly anemic, and 819 patients had moderate to severe anemia. With increasing severity of anemia, there was an increased average hospital length of stay (1.6 vs. 2.1 vs. 3.0 days,
conclusionWe found increasing severity of anemia to be associated with progressively worse 30-day postoperative outcomes. This is consistent with the outcomes found for increasing severity of anemia in patients receiving other total joint procedures. Using preoperative HCT levels may be a useful tool for predicting the risk of postoperative complications in patients undergoing TSA. This information could be used to further optimize patient selection for primary TSA.
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