Dehydration independently predicts prolonged hospital stay following aseptic revision total shoulder arthroplasty

TL;DR

This study shows that being dehydrated before surgery increases the risk of complications and longer hospital stays after a specific shoulder surgery.

Contribution

The study identifies dehydration as an independent predictor of prolonged hospital stay after aseptic revision total shoulder arthroplasty.

Findings

Dehydration was linked to a higher chance of postoperative complications.

Dehydration independently predicted a hospital stay longer than two days.

Dehydrated patients were more likely to be discharged to a non-home location.

Abstract

This study investigates the association between preoperative dehydration and 30-day postoperative complications following aseptic revision total shoulder arthroplasty (TSA).

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 groups based on preoperative hydration status: normal (blood urea nitrogen (BUN)/creatinine (Cr) < 25) and dehydration (BUN/Cr ≥ 25). Logistic regression analysis was conducted to investigate the relationship between preoperative dehydration and postoperative complications.

Compared to normal hydration, dehydration was associated with a significantly greater likelihood of experiencing any complication (P = 0.004), nonhome discharge (P = 0.002), and length of stay (LOS) > 2 days (P < 0.001). After controlling for potential confounding variables with multivariate analysis, dehydration was independently significantly associated with LOS > 2 days (odds ratio 1.50, 95% confidence interval 1.05–2.14; P = 0.028).

Preoperative dehydration status is associated with a greater rate of early postoperative complications and is an independent predictor of LOS exceeding two days following aseptic revision TSA. A better understanding of dehydration as a risk factor for postoperative complications may help surgeons better select surgical candidates and improve surgical outcomes in the setting of aseptic revision TSA.

Level III; Retrospective Cohort Comparison; Prognosis Study.

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