Evidence map›Paper›PMID 40781178›Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Hypoalbuminemia associated perioperative mortality, reoperation, and readmission rates among total joint arthroplasty procedures: a systematic review and meta-analysis.

Eric H Tischler, Sung Huang Laurent Tsai, Jake R McDermott, Shivasuryan Vummidi, Chun Ru Lin, Joshua Harounian, Jonathan M Gross, Nishant Suneja

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Eric H TischlerDepartment of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York Downstate Health Sciences University, Brooklyn, NY, 11203, USA.ORCID http://orcid.org/0000-0003-2098-0440
Sung Huang Laurent TsaiDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung 204, and School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
Jake R McDermottDepartment of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York Downstate Health Sciences University, Brooklyn, NY, 11203, USA.
Shivasuryan VummidiDepartment of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York Downstate Health Sciences University, Brooklyn, NY, 11203, USA.
Chun Ru LinDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung 204, and School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
Joshua HarounianDepartment of Orthopaedic Surgery and Rehabilitation Medicine, The State University of New York Downstate Health Sciences University, Brooklyn, NY, 11203, USA.
Jonathan M GrossDepartment of Orthopaedic Surgery, Staten Island University Hospital, Northwell Health, Staten Island, NY, 10305, USA.
Nishant SunejaDepartment of Orthopaedic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. nsuneja@bwh.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlbumin had consistently demonstrated an association with readmission, reoperation and mortality rates among total joint arthroplasty (TJA) patients. The currently literature demonstrates variable effect sizes of hypoalbuminemia and postoperative outcomes.

methodsPubMed/MEDLINE, Embase, Ovid, CENTRAL, the trial register, and Scopus were searched. Associations between preoperative albumin and postoperative readmission, reoperation, and mortality among TJA patients were determined. Zero-event rates were included with the Freeman-Tukey and study heterogeneity > 50% was accounted for with a random-effects model Subgroup analyses were conducted for total shoulder (TSA), knee (TKA), and hip arthroplasty (THA).

resultsTwenty-one eligible studies with 605,942 patients were included. Hypoalbuminemia reported a 1.99, 2.20, and 3.93 -fold increased odds of readmission (OR 1.99, 95% CI 1.66-2.39; p < 0.001), reoperation (OR 2.20, 95% CI 1.73-2.81; p < 0.001) and mortality (OR 3.93, 95% CI 2.56-6.05; p < 0.001), with significant respective heterogeneity of I2 = 90%, 78% and 95%. On subgroup analysis, hypoalbuminemia respectively exhibited 1.30 (OR 1.30, 95% CI 1.19-1.42; p < 0.001), 2.01 (OR 2.01, 95% CI 1.62-2.50; p < 0.001) and 1.88 (OR 1.88, 95% CI 0.58-6.12; p = 0.29) times increased odds of readmission for THA, TKA and TSA, respectively exhibited 1.70 (OR 1.70, 95% CI 1.22-2.38 p = 0.002), 2.67 (OR 2.67, 95% CI 1.38-5.16; p = 0.003) and 3.60 (OR 3.60, 95% CI 1.84-7.03; p = 0.0002) times increased odds of reoperation for THA, TKA and TSA,, and respectively exhibited 6.06 (OR 6.06, 95% CI 2.05-17.90; p = 0.001), 3.96 (OR 3.96, 95% CI 1.78-8.83; p = 0.0008) and 14.21 (OR 14.57, 95% CI 2.10-101.14; p = 0.007) times increased odds of mortality for THA, TKA and TSA.

conclusionAlthough serum albumin predicts post-TJA readmission, reoperation and mortality, the large variation in risk requires investigation of procedure and population specific thresholds for hypoalbuminemia.

Indexed as

Arthroplasty, ReplacementHypoalbuminemiaPatient ReadmissionPostoperative ComplicationsReoperationArthroplasty, Replacement, HipArthroplasty, Replacement, KneeHumansRisk FactorsAlbuminArthroplastyJointMeta-analysisOrthopaedic

Identifiers

PMID40781178

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.