identification of risk factors for abnormal postoperative chemistry labs after primary shoulder arthroplasty

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.