Blood transfusion in elective total hip arthroplasty: can patient-specific parameters predict transfusion?
Journal
Bone & joint open
ISSN: 2633-1462
Titre abrégé: Bone Jt Open
Pays: England
ID NLM: 101770336
Informations de publication
Date de publication:
07 Jul 2024
07 Jul 2024
Historique:
medline:
7
7
2024
pubmed:
7
7
2024
entrez:
6
7
2024
Statut:
epublish
Résumé
Transfusion after primary total hip arthroplasty (THA) has become rare, and identification of causative factors allows preventive measures. The aim of this study was to determine patient-specific factors that increase the risk of needing a blood transfusion. All patients who underwent elective THA were analyzed retrospectively in this single-centre study from 2020 to 2021. A total of 2,892 patients were included. Transfusion-related parameters were evaluated. A multiple logistic regression was performed to determine whether age, BMI, American Society of Anesthesiologists (ASA) grade, sex, or preoperative haemoglobin (Hb) could predict the need for transfusion within the examined patient population. The overall transfusion rate was 1.2%. Compared to the group of patients without blood transfusion, the transfused group was on average older (aged 73.8 years (SD 9.7) vs 68.6 years (SD 10.1); p = 0.020) and was mostly female (p = 0.003), but showed no significant differences in terms of BMI (28.3 kg/m The possibility of transfusion is predictable based on preoperatively available parameters. The proposed thresholds for preoperative Hb level, age, and BMI can help identify patients and take preventive measures if necessary.
Identifiants
pubmed: 38971574
doi: 10.1302/2633-1462.57.BJO-2023-0157.R1
pii: BJO-2023-0157.R1
doi:
Types de publication
Journal Article
Langues
eng
Pagination
560-564Informations de copyright
© 2024 Meißner et al.
Déclaration de conflit d'intérêts
A. Halder and D. Schrednitzki disclose consulting fees and payment for presentations from Zimmer Biomet. A. Halder is vice-president of the European Knee Society, all of which is unrelated to this paper.
Références
Rosencher N , Kerkkamp HEM , Macheras G , et al. Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe . Transfusion . 2003 ; 43 ( 4 ): 459 – 469 . 10.1046/j.1537-2995.2003.00348.x 12662278
Carling MS , Jeppsson A , Eriksson BI , Brisby H . Transfusions and blood loss in total hip and knee arthroplasty: a prospective observational study . J Orthop Surg Res . 2015 ; 10 : 48 . 10.1186/s13018-015-0188-6 25889413
Spiess BD . Transfusion of blood products affects outcome in cardiac surgery . Semin Cardiothorac Vasc Anesth . 2004 ; 8 ( 4 ): 267 – 281 . 10.1177/108925320400800402 15583789
Rawn J . The silent risks of blood transfusion . Curr Opin Anaesthesiol . 2008 ; 21 ( 5 ): 664 – 668 . 10.1097/ACO.0b013e32830f1fd1 18784496
Frisch NB , Wessell NM , Charters MA , Yu S , Jeffries JJ , Silverton CD . Predictors and complications of blood transfusion in total hip and knee arthroplasty . J Arthroplasty . 2014 ; 29 ( 9 Suppl ): 189 – 192 . 10.1016/j.arth.2014.03.048 25007727
Koch CG , Li L , Sun Z , et al. Hospital-acquired anemia: prevalence, outcomes, and healthcare implications . J Hosp Med . 2013 ; 8 ( 9 ): 506 – 512 . 10.1002/jhm.2061 23873739
Musallam KM , Tamim HM , Richards T , et al. Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study . Lancet . 2011 ; 378 ( 9800 ): 1396 – 1407 . 10.1016/S0140-6736(11)61381-0 21982521
Farrow L , Brasnic L , Martin C , et al. A nationwide study of blood transfusion in hip fracture patients : linked analysis from the Scottish Hip Fracture Audit and the Scottish National Blood Transfusion Service . Bone Joint J . 2022 ; 104-B ( 11 ): 1266 – 1272 . 10.1302/0301-620X.104B11.BJJ-2022-0450.R1 36317353
Wei W , Wei B . Comparison of topical and intravenous tranexamic acid on blood loss and transfusion rates in total hip arthroplasty . J Arthroplasty . 2014 ; 29 ( 11 ): 2113 – 2116 . 10.1016/j.arth.2014.07.019 25155138
Meißner N , Halder AM , Schrednitzki D . Cemented and hybrid total hip arthroplasty lead to lower blood loss in primary total hip arthroplasty: a retrospective study . Arch Orthop Trauma Surg . 2023 ; 143 ( 10 ): 6447 – 6451 . 10.1007/s00402-023-04851-9 37036500
Browne JA , Adib F , Brown TE , Novicoff WM . Transfusion rates are increasing following total hip arthroplasty: risk factors and outcomes . J Arthroplasty . 2013 ; 28 ( 8 Suppl ): 34 – 37 . 10.1016/j.arth.2013.03.035 23896359
Komnos GA , Manrique J , Foltz C , Klement MR , Restrepo C , Parvizi J . Transfusion rates in total hip arthroplasty are lower in patients with direct anterior approach . Arch Bone Jt Surg . 2021 ; 9 ( 6 ): 659 – 664 . 10.22038/ABJS.2021.50237.2497 35106331
Bedard NA , Pugely AJ , Lux NR , Liu SS , Gao Y , Callaghan JJ . Recent trends in blood utilization after primary hip and knee arthroplasty . J Arthroplasty . 2017 ; 32 ( 3 ): 724 – 727 . 10.1016/j.arth.2016.09.026 27866952
Meybohm P , Herrmann E , Steinbicker AU , et al. Patient blood management is associated with a substantial reduction of red blood cell utilization and safe for patient’s outcome: a prospective, multicenter cohort study with a noninferiority design . Ann Surg . 2016 ; 264 ( 2 ): 203 – 211 . 10.1097/SLA.0000000000001747 27163948
Magill P , Hill JC , Bryce L , et al. Oral tranexamic acid for an additional 24 hours postoperatively versus a single preoperative intravenous dose for reducing blood loss in total hip arthroplasty: results of a randomized controlled trial (TRAC-24) . Bone Joint J . 2021 ; 103-B ( 7 ): 1197 – 1205 . 10.1302/0301-620X.103B7.BJJ-2020-2309.R1 34192922
Lee QJ , Chang WYE , Wong YC . Blood-sparing efficacy of oral tranexamic acid in primary total hip arthroplasty . J Arthroplasty . 2017 ; 32 ( 1 ): 139 – 142 . 10.1016/j.arth.2016.06.058 27498390
Yue C , Kang P , Yang P , Xie J , Pei F . Topical application of tranexamic acid in primary total hip arthroplasty: a randomized double-blind controlled trial . J Arthroplasty . 2014 ; 29 ( 12 ): 2452 – 2456 . 10.1016/j.arth.2014.03.032 24793893
Hsu CH , Lin PC , Kuo FC , Wang JW . A regime of two intravenous injections of tranexamic acid reduces blood loss in minimally invasive total hip arthroplasty: A prospective randomised double-blind study . Bone Joint J . 2015 ; 97-B ( 7 ): 905 – 910 . 10.1302/0301-620X.97B7.35029 26130344
Zhao H , Xiang M , Xia Y , Shi X , Pei FX , Kang P . Efficacy of oral tranexamic acid on blood loss in primary total hip arthroplasty using a direct anterior approach: a prospective randomized controlled trial . Int Orthop . 2018 ; 42 ( 11 ): 2535 – 2542 . 10.1007/s00264-018-3846-6 29492612
Jeschke E , Citak M , Halder AM , et al. Blood transfusion and venous thromboembolism trends and risk factors in primary and aseptic revision total hip and knee arthroplasties: A nationwide investigation of 736,061 cases . Orthop Traumatol Surg Res . 2022 ; 108 ( 1 ): 102987 . 10.1016/j.otsr.2021.102987 34144253
Naathan H , Ilo K , Berber R , Matar HE , Bloch B . Are postoperative blood tests always required after lower limb arthroplasty? Bone Jt Open . 2023 ; 4 ( 5 ): 357 – 362 . 10.1302/2633-1462.45.BJO-2022-0124.R1 37195092
Saklad M . Grading of patients for surgical procedures . Anesthesiol . 1941 ; 2 ( 5 ): 281 – 284 .
S3-Leitlinie Prophylaxe der venösen Thromboembolie (VTE) . Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften . 2015 . https://register.awmf.org/assets/guidelines/003-001l_S3_VTE-Prophylaxe_2015-10-abgelaufen_01.pdf ( date last accessed 25 June 2024 ). Published in German.
Hochreiter J , Hejkrlik W , Emmanuel K , Hitzl W , Ortmaier R . Blood loss and transfusion rate in short stem hip arthroplasty: a comparative study . Int Orthop . 2017 ; 41 ( 7 ): 1347 – 1353 . 10.1007/s00264-016-3365-2 27942850
Carling MS , Jeppsson A , Eriksson BI , Brisby H . Transfusions and blood loss in total hip and knee arthroplasty: a prospective observational study . J Orthop Surg Res . 2015 ; 10 ( 1 ): 48 . 10.1186/s13018-015-0188-6 25889413
Pilz V , Hanstein T , Skripitz R . Projections of primary hip arthroplasty in Germany until 2040 . Acta Orthop . 2018 ; 89 ( 3 ): 308 – 313 . 10.1080/17453674.2018.1446463 29504824
Yeh JZY , Chen JY , Bin Abd Razak HR , et al. Preoperative haemoglobin cut-off values for the prediction of post-operative transfusion in total knee arthroplasty . Knee Surg Sports Traumatol Arthrosc . 2016 ; 24 ( 10 ): 3293 – 3298 . 10.1007/s00167-016-4183-1 27236540
Maempel JF , Wickramasinghe NR , Clement ND , Brenkel IJ , Walmsley PJ . The pre-operative levels of haemoglobin in the blood can be used to predict the risk of allogenic blood transfusion after total knee arthroplasty . Bone Joint J . 2016 ; 98-B ( 4 ): 490 – 497 . 10.1302/0301-620X.98B4.36245 27037431
Nuñez JH , Mora L , Carbonell C , et al. Is routine blood typing and screening necessary before primary total hip or knee arthroplasty in the 21st century? Transfusion . 2022 ; 62 ( 2 ): 316 – 323 . 10.1111/trf.16796 35044714