The impact of anemia on early postoperative complications in aseptic revision total shoulder arthroplasty

Background: This study investigates the association between preoperative anemia and 30-day postoperative complications following aseptic revision total shoulder arthroplasty (TSA). Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent aseptic revision TSA from 2015 to 2022. The study population was divided into two cohorts based on preoperative hematocrit (HCT): normal (Male HCT ≥ 41%; Female HCT ≥ 36%) and anemia (Male HCT < 41%; Female HCT < 36%). Logistic regression analysis was conducted to investigate the relationship between anemia and postoperative complications following aseptic revision TSA. Results: Anemia was independently associated with any complication (OR 1.71, 95% CI 1.40–2.10; P < 0.001), blood transfusions (OR 8.71, 95% CI 4.23–17.90; P < 0.001), non-home discharge (OR 1.81, 95% CI 1.26–2.60; P = 0.001), and length of stay exceeding 2 days (OR 1.81, 95% CI 1.43–2.29; P < 0.001). Conclusion: Patients with anemia experienced significantly higher rates of early postoperative complications after aseptic revision TSA. These findings provide evidence for the use of preoperative HCT measurements as a practical predictor of postoperative risk in this setting. Level of Evidence Level III; Retrospective Cohort Comparison; Prognosis Study.