JSES Reviews, Reports, and Techniques (Feb 2024)
Preoperative thrombocytopenia and thrombocytosis predict complications after arthroscopic rotator cuff repair
Abstract
Background: The purpose of this study was to investigate the association between preoperative platelet count and 30-day postoperative complications following arthroscopic rotator cuff repair (aRCR). Methods: The American College of Surgeons National Surgical Quality Improvement database was queried for all patients who underwent aRCR between 2015 and 2021. The study population was divided into 5 groups based on preoperative platelet count: normal (200-450k, reference cohort), low-normal (150-200k), mild thrombocytopenia (100-150k), moderate-to-severe thrombocytopenia (450k). Thirty-day postoperative complications following aRCR were collected. Multivariate logistic regression analysis was conducted to investigate the relationship between preoperative platelet counts and postoperative complications. Results: 24,779 patients were included in this study: 18,697 (75.5%) in the normal group, 4730 (19.1%) in the low-normal group, 1012 (4.1%) in the mild thrombocytopenia group, 171 (0.7%) in the moderate-to-severe thrombocytopenia group, and 169 (0.7%) in the thrombocytosis group. Low-normal platelets were an independent predictor of urinary tract infection (odds ratio [OR] 2.06, 95% confidence interval [CI] 1.12-3.77; P = .020). Mild thrombocytopenia was not an independent predictor of any complications. Moderate-to-severe thrombocytopenia was an independent predictor of sepsis (OR 9.39, 95% CI 1.48-59.47; P = .017), pneumonia (OR 6.62, 95% CI 1.32-33.24; P = .022), and nonhome discharge (OR 3.34, 95% CI 1.20-9.25; P = .021). Thrombocytosis was an independent predictor of urinary tract infection (OR 4.91, 95% CI 1.16-20.78; P = .030). Conclusion: Abnormal preoperative platelet counts, both low and high, were independent risk factors for 30-day postoperative complications following aRCR.
