How Does Iron-Deficiency Anemia Affect Total Shoulder Arthroplasty Complications?

Anemia is a common health condition that affects approximately one-quarter of the population and a significant portion of people undergoing elective joint replacement. In a study presented at the AAOS 2021 Annual Meeting, researchers examined how iron-deficiency anemia (IDA) impacts patients undergoing total shoulder arthroplasty (TSA).

The researchers, led by Teja Polisetty, BS, of Harvard Medical School, reported that patients with IDA had higher rates of complications and greater healthcare resource utilization, compared to patients without anemia.

Their retrospective analysis included more than 100,000 people undergoing TSA between 2005 and 2014: 17,689 patients with IDA and 88,445 matched controls. The groups were comparable in terms of age, gender, and comorbidities.

After undergoing TSA, patients with IDA had significantly higher rates of 90-day medical complications than matched controls (25.4% vs. 5.7%), including an increased risk of blood transfusion. Incidence of implant-related complications during the 90 days post-TSA were also higher for patients with IDA. Compared with matched controls, those with IDA also had longer in-hospital length of stay (3 days vs. 2 days) and higher episode-of-care costs ($14,661 vs. $13,062).

The findings from this study are limited by the lack of stratification according to IDA severity, as severity of the condition would likely impact use of healthcare resources.