Liu Steven H, Mahboubi Ardakani Rustin, Loyst Rachel A, Bramian Allen, Wang Edward D
University of Southern California, Los Angeles, USA.
Stony Brook Medicine, Stony Brook, USA.
Eur J Orthop Surg Traumatol. 2025 Jun 2;35(1):227. doi: 10.1007/s00590-025-04343-z.
This study investigates the association between preoperative leukopenia and leukocytosis with 30-day postoperative complications following noninfectious revision total shoulder arthroplasty (TSA).
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 three groups based on preoperative white blood cell (WBC) count: normal (WBC 4500-11,000), leukopenia (WBC ≤ 4500), and leukocytosis (WBC ≥ 11,000). Logistic regression analysis was conducted to investigate the relationship between WBC count and postoperative complications.
Compared to normal WBC counts, leukocytosis was independently associated with an increased likelihood of experiencing any complication (OR 1.71, 95% CI 1.13-2.59; P = 0.012), sepsis (OR 5.31, 95% CI 1.38-20.37; P = 0.015), non-home discharge (OR 2.18, 95% CI 1.18-4.05; P = 0.013), readmission (OR 2.76, 95% CI 1.36-5.63; P = 0.005), and LOS > 2 days (OR 1.68, 95% CI 1.06-2.66; P = 0.028). Compared to normal WBC counts, leukopenia was independently associated with an increased likelihood of experiencing pneumonia (OR 14.98, 95% CI 2.32-96.56; P = 0.004) and readmission (OR 2.78, 95% CI 1.49-5.17; P = 0.001).
The present study identified preoperative leukocytosis and leukopenia as independent risk factors for 30-day postoperative complications following revision TSA. Integrating WBC count into preoperative assessments can enhance the identification of patients at risk for postoperative complications, allowing for more tailored management strategies and potentially improving overall patient outcomes.
本研究调查非感染性翻修全肩关节置换术（TSA）后术前白细胞减少和白细胞增多与术后30天并发症之间的关联。
查询美国外科医师学会国家外科质量改进计划数据库中2015年至2022年接受非感染性翻修TSA的所有患者。根据术前白细胞（WBC）计数将研究人群分为三组：正常（WBC 4500 - 11,000）、白细胞减少（WBC≤4500）和白细胞增多（WBC≥11,000）。进行逻辑回归分析以研究WBC计数与术后并发症之间的关系。
与正常WBC计数相比，白细胞增多与发生任何并发症（比值比[OR]1.71，95%置信区间[CI]1.13 - 2.59；P = 0.012）、脓毒症（OR 5.31，95% CI 1.38 - 20.37；P = 0.015）、非回家出院（OR 2.18，95% CI 1.18 - 4.05；P = 0.013）、再次入院（OR 2.76，95% CI 1.36 - 5.63；P = 0.005）以及住院时间>2天（OR 1.68，95% CI 1.06 - 2.66；P = 0.028）的可能性增加独立相关。与正常WBC计数相比，白细胞减少与发生肺炎（OR 14.98，95% CI 2.32 - 96.56；P = 0.004）和再次入院（OR 2.78，95% CI 1.49 - 5.17；P = 0.001）的可能性增加独立相关。
本研究确定术前白细胞增多和白细胞减少是翻修TSA后3天术后并发症的独立危险因素。将WBC计数纳入术前评估可增强对术后并发症风险患者的识别，从而制定更具针对性的管理策略并可能改善患者总体预后。
