hypoalbuminemia and the higher risk of perioperative sentinel adverse events in patients undergoing total shoulder arthroplasty: a propensity score matched analysis

Background: the purpose of this study is to examine the effect of hypoalbuminemia (ha) on sentinel adverse eventsafter total shoulder arthroplasty (tsa).methods: patients who underwent primary tsa from 2015-2018 were collected from the national surgical qualityimprovement program (nsqip) database. patients with ha (serum albumin < 3.5 g/dl) were compared to patients withnormal serum albumin. a probit regression model was used to estimate a propensity score. logistic regression wasperformed to evaluate the effect of ha on sentinel adverse events after surgery.results: a total of 4,337 patients were included, 8.2% of patients had ha. patients with ha had higher rates ofsentinel adverse events (14.0% vs 5.5%, p<0.01) compared with patients who had normal serum albumin. reoperation(4.5% vs 1.5%, p<0.01), readmission (11.2% vs 3.9%, p<0.01), urinary tract infection (0.8% vs 0.03%, p<0.01) andpulmonary embolism (1.1% vs 0.2%, p=0.01) were higher in patients with ha. the odds ratio for a sentinel event forpatients with ha was 2.6 (95% ci: 1.54, 4.44, p<0.01) when compared to a propensity score-matched control group.conclusion: patients with ha are at increased risk of sentinel adverse events following tsa compared to patients withnormal serum albumin levels.level of evidence: ii