Hypoalbuminemia Predicts Adverse Events following Unicompartmental Knee Arthroplasty

Abstract

Hypoalbuminemia is a potentially modifiable risk factor associated with adverse events following total knee arthroplasty. The present study aimed to evaluate whether hypoalbuminemia similarly predisposes to adverse events following unicompartmental knee arthroplasty (UKA). Patients who underwent UKA during 2006–2018 were identified through the American College of Surgeons National Surgical Quality Improvement Program. Only patients with preoperative serum albumin concentration were included. Outcomes were compared between patients with and without hypoalbuminemia (serum albumin concentration < 3.5 g/dL). All associations were adjusted for demographic, comorbidity, and laboratory differences between populations. A total of 11,342 patients were identified, of whom 6,049 (53.3%) had preoperative serum albumin laboratory values available for analysis. After adjustment for potential confounders, patients with hypoalbuminemia had a greater than 2-fold increased probability for occurrence of any complication (7.02% vs. 2.23%, p = 0.009) and a 4-fold increased probability of receiving a blood transfusion (1.81% vs. 0.25%, p = 0.045). Among procedures performed as inpatients, mean postoperative length of stay (LOS) was longer in patients with hypoalbuminemia (2.2 vs. 1.8 days; p = 0.031). Hypoalbuminemia is independently associated with complications and increased LOS following UKA and a marker for patients at higher risk of postoperative complications. Patients should be screened for hypoalbuminemia and nutritional deficiencies addressed prior to UKA.

Relationship Between Preoperative Hypoalbuminemia and Postoperative Pneumonia Following Geriatric Hip Fracture Surgery: A Propensity-Score Matched and Conditional Logistic Regression Analysis

“…In studies of hip or knee joint arthroplasty, researchers have found patients suffering preoperative hypoalbuminemia had a 1.9 to 2.0-fold increased risk of any postoperative adverse events and 4-fold increased risk of blood transfusion, respectively. 27 , 28 Seong-Eun et al 29 retrospectively analyzed 519 elderly patients with hip fracture and found that the incidence of preoperative malnutrition in patients with aspiration pneumonia was significantly higher than that in the control group (36.8% vs 9.1%). Toshihiro et al 30 investigated 426 elderly patients undergoing surgery for hip fracture and found postoperative hypoalbuminemia was associated with 5.8-fold increased risk of postoperative pneumonia.…”

Prediction of intraoperative red blood cell transfusion in valve replacement surgery: machine learning algorithm development based on non-anemic cohort

“…Recently, a range of study found that preoperative intravenous iron treatment would significantly increase hemoglobin level ( 34 ) and reduce allogeneic transfusion ( 35 ) in non-anemic patients with iron deficiency undergoing cardiac surgery, supporting our findings about the impact of iron deficiency on non-anemic patients. In addition, another indicator that can be corrected preoperatively was hypoalbuminemia, which was reported as a risk factor of transfusion in other kinds of surgeries ( 36 , 37 ). Of note, diabetes was not included in the machine learning model, while high HbA1c was adopted as a risk factor.…”