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Elevated alkaline phosphatase independently predicts early postoperative complications in noninfectious revision total shoulder arthroplasty

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

This study investigates the association between preoperative serum alkaline phosphatase levels and 30 day postoperative complications following noninfectious revision total shoulder arthroplasty (TSA). We hypothesize that elevated alkaline phosphatase levels are significantly associated with an increased 30 day postoperative complication rate.

Methods

The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent noninfectious revision TSA from 2015 to 2022. The study population was divided into two groups based on preoperative serum alkaline phosphatase: normal (44–147 IU/L) and elevated (> 147 IU/L). Logistic regression analysis was conducted to investigate the relationship between elevated alkaline phosphatase levels and postoperative complications.

Results

Compared to normal levels, elevated alkaline phosphatase was independently associated with a significantly greater likelihood of experiencing any complications (odds ratio [OR] 2.54, 95% confidence interval [CI] 1.41–4.55; P = .002), sepsis (OR 9.96, 95% CI 1.67–59.29; P = .012), blood transfusions (OR 3.77, 95% CI 1.48–9.61; P = .005), readmission (OR 3.65, 95% CI 1.48–9.01; P = .005), and length of stay > 2 days (OR 2.37, 95% CI 1.31–4.30; P = .004).

Conclusions

Elevated preoperative alkaline phosphatase was associated with a greater rate of early postoperative complications following noninfectious revision TSA.

Level of Evidence

Level III; Retrospective Cohort Comparison; Prognosis Study.

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Authors and Affiliations

  1. Department of Orthopaedics, Stony Brook University, Stony Brook, NY, 11794, USA

    Steven H. Liu, Christian J. Leonardo, Rachel A. Loyst, Patricia Cerri-Droz, Andrew Zhu & Edward D. Wang

  2. Department of Orthopaedics, University of California Irvine, Orange, CA, USA

    Brandon Lung

Authors
  1. Steven H. Liu
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  2. Christian J. Leonardo
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  3. Rachel A. Loyst
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  4. Patricia Cerri-Droz
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  5. Brandon Lung
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  6. Andrew Zhu
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  7. Edward D. Wang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Steven H. Liu and Rachel A. Loyst. The first draft of the manuscript was written by Steven H. Liu and Christian J. Leonardo and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Steven H. Liu.

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The authors have no relevant financial or non-financial interests to disclose.

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Ethical approval was not sought for the present study because this study was exempt from IRB approval. This study was completed in accordance with the Helsinki Declaration as revised in 2013.

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Liu, S.H., Leonardo, C.J., Loyst, R.A. et al. Elevated alkaline phosphatase independently predicts early postoperative complications in noninfectious revision total shoulder arthroplasty. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03902-0

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