Allogeneic Blood Transfusions and Postoperative Infections After Total Hip or Knee Arthroplasty

2014 ◽  
Vol 96 (4) ◽  
pp. 272-278 ◽  
Author(s):  
Richard Friedman ◽  
Martin Homering ◽  
Gerlind Holberg ◽  
Scott D. Berkowitz
Keyword(s):  
Knee Arthroplasty ◽  
Allogeneic Blood ◽  
Blood Transfusions ◽  
Postoperative Infections ◽  
Total Hip

Autologous wound drains have no effect on allogeneic blood transfusions in primary total hip and knee replacement

2014 ◽  
Vol 96-B (6) ◽  
pp. 765-771 ◽  
Author(s):  
B. J. W. Thomassen ◽  
P. H. C. den Hollander ◽  
H. H. Kaptijn ◽  
R. G. H. H. Nelissen ◽  
P. Pilot
Keyword(s):  
Knee Replacement ◽  
Allogeneic Blood ◽  
Blood Transfusions ◽  
Total Hip

scholarly journals Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Thomas Danninger ◽  
Rehana Rasul ◽  
Jashvant Poeran ◽  
Ottokar Stundner ◽  
Madhu Mazumdar ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Regression Models ◽  
The United States ◽  
Perioperative Outcomes ◽  
Blood Transfusions ◽  
Logistic Regression Models ◽  
Total Hip ◽  
Major Complications

Background.Various studies have raised concern of worse outcomes in patients receiving blood transfusions perioperatively compared to those who do not. In this study we attempted to determine the proportion of perioperative complications in the orthopedic population attributable to the use of a blood transfusion.Methods.Data from 400 hospitals in the United States were used to identify patients undergoing total hip or knee arthroplasty (THA and TKA) from 2006 to 2010. Patient and health care demographics, as well as comorbidities and perioperative outcomes were compared. Multivariable logistic regression models were fitted to determine associations between transfusion, age, and comorbidities and various perioperative outcomes. Population attributable fraction (PAF) was determined to measure the proportion of outcome attributable to transfusion and other risk factors.Results.Of 530,089 patients, 18.93% received a blood transfusion during their hospitalization. Patients requiring blood transfusion were significantly older and showed a higher comorbidity burden. In addition, these patients had significantly higher rates of major complications and a longer length of hospitalization. The logistic regression models showed that transfused patients were more likely to have adverse health outcomes than nontransfused patients. However, patients who were older or had preexisting diseases carried a higher risk than use of a transfusion for these outcomes. The need for a blood transfusion explained 9.51% (95% CI 9.12–9.90) of all major complications.Conclusions.Advanced age and high comorbidity may be responsible for a higher proportion of adverse outcomes in THA and TKA patients than blood transfusions.

scholarly journals Blood Salvage in Total Hip and Knee Arthroplasty in a Community Hospital: A Retrospective Study

2005 ◽  
Vol 13 (1) ◽  
pp. 19-26 ◽  
Author(s):  
R Jain ◽  
S Jain
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Blood Salvage ◽  
Total Hip ◽  
Total Knee ◽  
Knee And Hip Arthroplasty

Purposes: To assess the results of postoperative and intra-operative blood salvage in patients undergoing total knee and hip arthroplasty, respectively, and to determine if both methods of blood salvage reduce allogeneic transfusion. Methods: Of 229 patients who attempted blood salvage, 114 of 152 patients who underwent total knee arthroplasty received the salvaged blood postoperatively, 35 of 77 patients who underwent total hip arthroplasty received the salvaged blood intra-operatively. Various data were collected to assess whether certain factors resulted in autologous and/or allogeneic blood transfusions. Results: Patients that received postoperative salvaged blood after total knee arthroplasty generally had higher postoperative levels of haemoglobin and haematocrit compared to those who did not. Patients with autologous blood transfusion following cemented knee surgery were less likely to require allogeneic blood transfusion. For hip arthroplasty patients, postoperative levels of haemoglobin and haematocrit were similar in both groups who received and did not receive salvaged blood. Lower preoperative haemoglobin and haematocrit levels correlated with a greater likelihood of autologous and/or allogeneic blood transfusion for both knee and hip arthroplasty patients. Conclusions: Although total knee arthroplasty patients who received salvaged blood had higher haemoglobin levels on the first postoperative day, the receipt of salvaged blood did not significantly reduce the incidence of allogeneic blood transfusion, because salvaged blood was a kind of blood loss. However, reinfusion of salvaged blood may reduce the number of units of allogeneic blood used. Given the short supply of allogeneic blood and its risks of transmitting disease, intra-operative and postoperative blood salvage carries clear advantages.

scholarly journals Postoperative Noninvasive Hemoglobin Monitoring Is Useful to Prevent Unnoticed Postoperative Anemia and Inappropriate Blood Transfusion in Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
pp. 215145932110605
Author(s):  
Erisa Nakamori ◽  
Kenji Shigematsu ◽  
Midoriko Higashi ◽  
Ken Yamaura
Keyword(s):  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Controlled Study ◽  
Control Group ◽  
Total Hip ◽  
Randomized Controlled ◽  
Primary Endpoints

Introduction Postoperative nadir hemoglobin (Hb) is related to a longer length of stay for geriatric patients undergoing orthopedic surgery. We investigated whether postoperative pulse Hb (SpHb) measurement is useful for avoiding anemia and inappropriate blood transfusion after total hip arthroplasty and total knee arthroplasty. Material and Methods This prospective randomized controlled study included 150 patients randomly assigned to receive blood transfusion, either guided by SpHb monitoring (SpHb group) or based on the surgeons’ experience (control group). The target laboratory Hb value was set to >8 g/dL at postoperative day 1 (POD1). The primary endpoints were the product of total time and degree of SpHb <8 g/dL (area under SpHb 8 g/dL) during the period up to POD1 and the incidence of laboratory Hb <8 g/dL at POD1. The secondary endpoints were the amount of blood transfusion and inappropriate blood transfusion, which was defined as allogeneic blood transfusion unnecessary in a case of SpHb >12 g/dL or delayed transfusion in a case of SpHb <8 g/dL. Results The area under SpHb 8 g/dL was 37.6 ± 44.1 g/dL-min (5 patients) in the control group and none in the SpHb group ( P = .0281). There was 1 patient with Hb <8 g/dL at POD1 in the control group. There was no difference in laboratory Hb levels and the amount of blood transfusion. Forty-one patients (19 in the control group and 22 in the SpHb group) received an allogeneic blood transfusion. Among these patients, 7 in the control group and none in the SpHb group received inappropriate blood transfusion ( P = .0022). Discussion The SpHb monitoring could reduce unnoticed anemia, which may prevent complications and be useful in avoiding unnecessary and excessive blood transfusion. Conclusion Postoperative SpHb monitoring decreased the incidence of transient, unnoticed anemia during the period up to POD1 and inappropriate blood transfusion.

scholarly journals Modifiable Individual Risks of Perioperative Blood Transfusions and Acute Postoperative Complications in Total Hip and Knee Arthroplasty

2021 ◽  
Vol 11 (11) ◽  
pp. 1223
Author(s):  
Axel Jakuscheit ◽  
Nina Schaefer ◽  
Johannes Roedig ◽  
Martin Luedemann ◽  
Sebastian Philipp von Hertzberg-Boelch ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Haemoglobin Concentration ◽  
Blood Transfusions ◽  
Preoperative Treatment ◽  
Complication Rates ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
Low Bmi

Background: The primary aim of this study was to identify modifiable patient-related predictors of blood transfusions and perioperative complications in total hip and knee arthroplasty. Individual predictor-adjusted risks can be used to define preoperative treatment thresholds. Methods: We performed this retrospective monocentric study in orthopaedic patients who underwent primary total knee or hip arthroplasty. Multivariate logistic regression models were used to assess the predictive value of patient-related characteristics. Predictor-adjusted individual risks of blood transfusions and the occurrence of any perioperative adverse event were calculated for potentially modifiable risk factors. Results: 3754 patients were included in this study. The overall blood transfusion and complication rates were 4.8% and 6.4%, respectively. Haemoglobin concentration (Hb, p < 0.001), low body mass index (BMI, p < 0.001) and estimated glomerular filtration rate (eGFR, p = 0.004) were the strongest potentially modifiable predictors of a blood transfusion. EGFR (p = 0.001) was the strongest potentially modifiable predictor of a complication. Predictor-adjusted risks of blood transfusions and acute postoperative complications were calculated for Hb and eGFR. Hb = 12.5 g/dL, BMI = 17.6 kg/m2, and eGFR = 54 min/mL were associated, respectively, with a 10% risk of a blood transfusion, eGFR = 59 mL/min was associated with a 10% risk of a complication. Conclusion: The individual risks for blood transfusions and acute postoperative complications are strongly increased in patients with a low preoperative Hb, low BMI or low eGFR. We recommend aiming at a preoperative Hb ≥ 13g/dL, an eGFR ≥ 60 mL/min and to avoid a low BMI. Future studies must show if a preoperative increase of eGFR and BMI is feasible and truly beneficial.

Allogeneic blood transfusions and postoperative infections after lumbar spine surgery

2015 ◽  
Vol 15 (5) ◽  
pp. 901-909 ◽  
Author(s):  
Stein J. Janssen ◽  
Yvonne Braun ◽  
Kirkham B. Wood ◽  
Thomas D. Cha ◽  
Joseph H. Schwab
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Allogeneic Blood ◽  
Lumbar Spine Surgery ◽  
Blood Transfusions ◽  
Postoperative Infections
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