Routine postoperative laboratory tests are unnecessary after primary reverse shoulder arthroplasty

Paynter, Jordan W.; Raley, James A.; Kyrkos, Judith G.; Paré, Daniel W.; Houston, Harrison; Crosby, Lynn A.; Parada, Stephen A.

doi:10.1016/j.jse.2019.12.023

Cited by 14 publications

(14 citation statements)

References 28 publications

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“…For example, nutritionists are in charge of evaluating the patient’s nutritional condition and correcting nutritional deficiencies, such as hypoalbuminemia and nutritional anaemia. Previous studies have reported that the utility of postoperative laboratory testing was both unnecessary and cost-inefficient following joint arthroplasty [ 7 , 23 – 25 ]. The study by Wu et al [ 25 ] included that the incidences of abnormal postoperative laboratory results and interventions associated with abnormal values after THA were 88.4 and 6.8%, respectively, which were similar to the findings in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Jurisson et al [ 30 ] retrospectively reviewed 8298 patients with incident femoral neck fractures and reported that the presence of preinjury comorbid conditions raised the risk of excess death in hip fracture patients. Jordan et al [ 7 ] showed that 87.3% of postoperative laboratory tests did not lead to alterations in postoperative treatment, and a lower BMI, higher CCI and chronic kidney disease were proven to be risk factors for postoperative laboratory abnormalities via univariable analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Surgeons are accustomed to performing postoperative laboratory tests routinely after joint replacement without evidence as to whether they are necessary. However, previous studies provided evidence that the application of routine postoperative laboratory tests was not required in patients with joint arthroplasty unless patients were at risk for laboratory testing abnormalities [ 7 – 9 ]. With the development of enhanced recovery after surgery (ERAS) in the field of joint replacement, vast advancements have been obtained in hip hemiarthroplasty in terms of both operative techniques and perioperative management [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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The role of routine postoperative laboratory tests following hip hemiarthroplasty for an elderly femoral neck fracture

Zhuang

Huan

Luo

et al. 2021

BMC Musculoskelet Disord

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Background Performing postoperative laboratory tests following joint arthroplasty is a regular practice. However, the role of routine postoperative laboratory tests in primary hip arthroplasty is currently in doubt. This study aimed to assess the role of routine postoperative laboratory tests for femoral neck fractures in elderly patients who underwent hip hemiarthroplasty and to evaluate the risk factors for postoperative laboratory testing abnormalities and related interventions. Methods This retrospective study reviewed 735 consecutive patients with femoral neck fractures (FNFs) who underwent hip hemiarthroplasty at a single tertiary academic organization. Patient characteristic features and laboratory testing values were recorded. Logistic regression models were calculated to identify risk factors. Results A total of 321 elderly patients (> 75 years of age) were ultimately enrolled for analysis. Abnormal postoperative laboratory tests were found in 265 patients (82.6%). Only a minority of the included patients (7.5%) needed medical intervention to treat postoperative laboratory testing abnormalities. Multivariate logistic regression analysis reported that a higher Charlson comorbidity index (CCI) (P = 0.03), abnormal preoperative haemoglobin level (P < 0.01), higher intraoperative blood loss (P < 0.01) and less frequent tranexamic acid use (P = 0.05) were risk factors for abnormal postoperative laboratory tests. Furthermore, a higher CCI has been identified as a risk factor for patients needing clinical interventions related to laboratory abnormalities. Conclusions Because 92.5% of laboratory tests did not influence postoperative management, the authors suggest that routine laboratory tests after hip hemiarthroplasty for FNFs are less instructive for the majority of elderly patients. Nevertheless, for patients with identified risk factors, postoperative laboratory tests are still required to identify the abnormalities that need to be managed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The role of routine postoperative laboratory tests following hip hemiarthroplasty for an elderly femoral neck fracture

Zhuang

Huan

Luo

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

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“…Recently, several studies have consistently revealed that routine postoperative laboratory tests are not necessary for patients following orthopedic surgery or even joint replacement surgery, unless patients have a history of preoperative abnormal laboratory test [ 6 – 8 ]. However, few studies have reported the necessity of routine laboratory tests in patients following HTO surgery.…”

Section: Introductionmentioning

confidence: 99%

Re-evaluating the necessity of routine laboratory tests after high tibial osteotomy surgery

Nie

Lan

et al. 2021

BMC Musculoskelet Disord

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Background To assess the utility of routine postoperative laboratory tests for patients undergoing high tibial osteotomy (HTO) surgery. Methods The associations between clinical risk factors and postoperative clinical treatment were analyzed. Additionally, a logistic regression analysis was performed to detect independent risk factors for patients requiring postoperative clinical treatment. Results A total of 482 patients with symptomatic isolated medial compartment osteoarthritis from January 2015 to May 2020 were included in the present study and underwent examination by the full set of postoperative laboratory tests within 3 days after HTO surgery. However, only a small proportion of the patients with anemia (3.9 %), hypoalbuminemia (4.1 %), and abnormal serum potassium levels (3.5 %) required clinical intervention after surgery. Binary logistic regression analysis showed that the body mass index (BMI), preoperative hemoglobin level, estimated blood loss and operative duration were independent risk factors for postoperative blood transfusion in patients who underwent HTO surgery, and factors associated with albumin supplementation were female sex and preoperative albumin level. In addition, these results indicated that preoperative potassium was potential risk factor for patients who required potassium supplementation postoperatively. Conclusions Based on the analysis, we conclude that routinely ordering postoperative laboratory tests after HTO surgery is unnecessary. However, for patients with identified risk factors, routine postoperative laboratory tests are still needed.

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“…Cost effectiveness is an increasingly important consideration in the delivery of health care. Recently, several studies have consistently revealed that routine postoperative laboratory tests are not necessary for patients after major orthopedic surgery, unless patients had a history of disease associated with an abnormal laboratory test [6][7][8]. However, few studies have reported the necessity for routine laboratory tests for patients after HTO surgery.…”

Section: Introductionmentioning

confidence: 99%

Are Routine Postoperative Laboratory Tests Really Necessary after High Tibial Osteotomy surgery?

Nie

Lan

et al. 2021

Preprint

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Background: The purpose of this study was to assess the necessity and cost-effectiveness of routine postoperative laboratory tests for patients undergoing high tibial osteotomy (HTO) surgery.Methods: A prospective study was conducted and 513 patients with symptomatic isolated medial compartment osteoarthritis received HTO surgery from January 2015 to May 2020 were included in this study. The associations between different clinical factors and postoperative clinical treatment were analyzed. Finally, A logistic regression analysis was performed to detect independent risk factors for patients requiring postoperative clinical treatment. Results: In this study, 482 patients had completed the full set of postoperative laboratory studies within 3 days after surgery were included in the present study. However, only a small proportion of the patients with anemia (3.9%), hypoalbuminemia (4.1%), and abnormal serum potassium levels (3.5%) required clinical intervention after surgery. Binary logistic regression model analysis showed that body mass index (BMI), preoperative hemoglobin level, estimated blood loss and operative time were the independent risk factors correlated with postoperative blood transfusion in patients with HTO surgery. Female gender and preoperative albumin level were independent risk factors for patients who had requiring albumin supplementation after HTO surgery. Finally, preoperative potassium was the independent risk factors for patients required potassium supplementation postoperatively.Conclusions: based on the analysis, we conclude that routinely ordering postoperative laboratory studies after HTO surgery are both unnecessary and cost inefficient. However, for patients with identified risk factors, routine postoperative laboratory tests are still needed.

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Routine postoperative laboratory tests are unnecessary after primary reverse shoulder arthroplasty

Cited by 14 publications

References 28 publications

The role of routine postoperative laboratory tests following hip hemiarthroplasty for an elderly femoral neck fracture

The role of routine postoperative laboratory tests following hip hemiarthroplasty for an elderly femoral neck fracture

Re-evaluating the necessity of routine laboratory tests after high tibial osteotomy surgery

Are Routine Postoperative Laboratory Tests Really Necessary after High Tibial Osteotomy surgery?

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