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. 2018 Jul;6(4):282-288.

Identification of Risk Factors for Abnormal Postoperative Chemistry Labs after Primary Shoulder Arthroplasty

Alexis A Williams  1   2 , Eric H Tischler  1   2 , Daniel Sholder  1   2 , Thema A Nicholson  1   2 , Mitchell G Maltenfort  1   2 , Charles Getz  1   2 , Gerald Williams Jr  1   2 , Surena Namdari  1   2
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Identification of Risk Factors for Abnormal Postoperative Chemistry Labs after Primary Shoulder Arthroplasty

Alexis A Williams et al. Arch Bone Jt Surg. 2018 Jul.

Abstract

Background: 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.

Keywords: blood chemistry; laboratory order; reverse shoulder arthroplasty; risk stratification; total shoulder arthroplasty.

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References

    1. Kraft MD, Btaiche IF, Sacks GS, Kudsk KA. Treatment of electrolyte disorders in adult patients in the intensive care unit. Am J Health Syst Pharm. 2005;62(16):1663–82. - PubMed
    1. Tambe AA, Hill R, Livesley PJ. Post-operative hyponatraemia in orthopaedic injury. Injury. 2003;34(4):253–5. - PubMed
    1. Anthony CA, Westermann RW, Gao Y, Pugely AJ, Wolf BR, Hettrich CM. What are risk factors for 30-day morbidity and transfusion in total shoulder arthroplasty? A review of 1922 cases. Clin Orthop Relat Res. 2015;473(6):2099–105. - PMC - PubMed
    1. Jiang JJ, Toor AS, Shi LL, Koh JL. Analysis of perioperative complications in patients after total shoulder arthroplasty and reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2014;23(12):1852–9. - PubMed
    1. Waterman BR, Dunn JC, Bader J, Urrea L, Schoenfeld AJ, Belmont PJ Jr. Thirty-day morbidity and mortality after elective total shoulder arthroplasty: patient-based and surgical risk factors. J Shoulder Elbow Surg. 2015;24(1):24–30. - PubMed

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