Hypoalbuminemia predicts early postoperative complications following noninfectious revision total shoulder arthroplasty

Purpose: This study investigates the association between preoperative hypoalbuminemia and 30-day postoperative complications following noninfectious revision total shoulder arthroplasty (TSA). Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent noninfectious revision TSA from 2015 to 2021. The study population was divided into two groups based on preoperative serum albumin: normal albumin (≥ 3.5 g/dL) and hypoalbuminemia (< 3.5 g/dL). Logistic regression analysis was conducted to investigate the relationship between preoperative hypoalbuminemia and postoperative complications. Results: Compared to normal albumin, hypoalbuminemia was independently associated with a significantly greater likelihood of experiencing any complication (odds ratio [OR] 3.26, 95% confidence interval [CI] 2.04–5.19; P <.001), sepsis (OR 9.92, 95% CI 1.29–76.35; P =.028), blood transfusions (OR 2.89, 95% CI 1.20–6.93; P =.017), non-home discharge (OR 2.88, 95% CI 1.55–5.35; P <.001), readmission (OR 3.46, 95% CI 1.57–7.58; P =.002), and length of stay > 2 days (OR 3.00, 95% CI 1.85–4.86; P <.001). Conclusions: Preoperative hypoalbuminemia was associated with early postoperative complications following revision TSA. Level of evidence: Level III; Retrospective Cohort Comparison; Prognosis Study.