Risk factors for postoperative blood transfusion after shoulder arthroplasty

Kyle J. Kopechek, Travis L. Frantz, Joshua S. Everhart, Richard Samade, Julie Y. Bishop, Andrew S. Neviaser, Gregory L. Cvetanovich

Research output: Contribution to journalArticlepeer-review


Purpose: To identify the effect of surgical indication, patient factors, and perioperative characteristics on transfusion after shoulder arthroplasty (SA). Methods: Shoulder arthroplasties for osteoarthritis (OA) (N = 47), rotator cuff arthropathy (RCA) (N = 50), fracture (N = 76), revision (N = 66), and periprosthetic joint infection (PJI) (N = 35) performed at a single institution during a 6-year period were included. All other indications were excluded. Patient-based and surgical risk factors, including surgical indication, for postoperative allogeneic red blood cell transfusion were assessed with multivariate logistic regression analysis. Results: A total of 274 SAs were included; transfusions were performed in 2% (2/97) of primary SAs for OA or RCA. Increased transfusion rates occurred in PJI (23%, p = 0.0006) and fracture (18%, p = 0.0018) cases. The mean preoperative hemoglobin (Hgb) was 12.2 ± 2.2 with PJI, 12.0 ± 2.1 with fracture, and 13.3 ± 1.6 g/dL for all other SAs. Independent risk factors for transfusion included lower preoperative hemoglobin (p < 0.001), PJI indication (p = 0.008), and fracture indication (p = 0.02), with no difference for fracture greater or less than 4 weeks old (p = 0.53). Conclusion: Risk factors for allogeneic red blood cell transfusion after SA were low preoperative hemoglobin and procedures for PJI or fracture.

Original languageEnglish (US)
Pages (from-to)254-262
Number of pages9
JournalShoulder and Elbow
Issue number3
StatePublished - Jun 2022
Externally publishedYes


  • postoperative blood transfusion
  • preoperative hemoglobin
  • reverse total shoulder arthroplasty
  • risk factors
  • Shoulder arthroplasty
  • total shoulder arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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