Decline in allogeneic blood transfusion usage in total hip arthroplasty patients: National Inpatient Sample 2009 to 2013

2017 ◽  
Vol 28 (4) ◽  
pp. 382-390 ◽  
Author(s):  
Chukwuweike U. Gwam ◽  
Jaydev B. Mistry ◽  
Jennifer I. Etcheson ◽  
Nicole E. George ◽  
Grayson Connors ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Blood Transfusion ◽  
Hip Arthroplasty ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
National Inpatient Sample ◽  
Allogeneic Transfusion ◽  
Total Hip ◽  
Primary Thas

Introduction: Although total hip arthroplasty (THA) is an effective treatment for end-stage arthritis, it is also associated with substantial blood loss that may require allogeneic blood transfusion. However, these transfusions may increase the risk of certain complications. The purpose of our study is to evaluate: (i) the incidence/trends of allogeneic blood transfusion; (ii) the associated risk factors and adverse events; and (iii) the discharge disposition, length of stay (LOS), and costs for these patients between 2009 and 2013. Methods: The National Inpatient Sample database was used to identify 1,542,366 primary THAs performed between 2009 and 2013. Patients were stratified based on demographics, economic data, hospital characteristics, comorbidities, and whether or not allogeneic transfusion was received. Logistic regression was performed to evaluate the risk factors for transfusion and postoperative complications. Results: From 2009 to 2013, allogeneic transfusions were used in 16.9% of primary THAs, with a declining annual incidence. Except for obesity, all comorbidities were associated with increased likelihood of receiving a transfusion. Allogeneic transfusion patients were more likely to experience surgical site infections or pulmonary complications (p<0.001 for all). These patients were more likely to be discharged to a short-term care facility (p<0.001). Additionally, they had a greater mean LOS (p<0.001) and higher median hospital costs and charges when compared to their non-transfused counterparts. Conclusions: While the observed decline in allogeneic transfusion usage is encouraging, further efforts should focus on preoperative patient optimisation. Given the projected increase in demand for primary THAs, orthopaedic surgeons must be familiar with safe and effective blood conservation protocols.

Relative Risk Factors for Requirement of Blood Transfusion after Total Hip Arthroplasty

2007 ◽  
Vol 22 (8) ◽  
pp. 1162-1167 ◽  
Author(s):  
Michael Walsh ◽  
Charles Preston ◽  
Matthew Bong ◽  
Vipul Patel ◽  
Paul E. Di Cesare
Keyword(s):  
Risk Factors ◽  
Relative Risk ◽  
Total Hip Arthroplasty ◽  
Blood Transfusion ◽  
Hip Arthroplasty ◽  
Total Hip

scholarly journals Risk Factors for Blood Transfusion After Primary Total Hip Arthroplasty

2019 ◽  
Vol 9 ◽  
Author(s):  
Kyle K. Kesler ◽  
Timothy S. Brown ◽  
J. Ryan Martin ◽  
Bryan D. Springer ◽  
Jesse Otero
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Total Hip Arthroplasty ◽  
Blood Transfusion ◽  
Hip Arthroplasty ◽  
Univariate Analysis ◽  
Chronic Obstructive ◽  
Complication Rates ◽  
Improvement Project ◽  
Total Hip

Aims: In the setting of rising healthcare costs, more cost efficiency in total hip arthroplasty (THA) is required. Following THA, most patients are monitored with serial hemoglobin testing despite few needing blood transfusions.  This testing adds cost and may not be necessary in most patients.  This study aims to identify factors associated with transfusion, therefore guiding hemoglobin monitoring following THA.Patients and Methods: Patients who underwent primary THA in 2015 were identified using the National Surgical Quality Improvement Project (NSQIP) database.  Patient discharged on the day of surgery were excluded. Patients were classified into those receiving transfusion versus no transfusion. Demographics and comorbidities were compared between groups followed by univariate and multivariate analysis, allowing identification of patient characteristics and comorbidities associated with transfusion. Results: Overall, 28664 patients who underwent THA patients were identified.  Within this group, 6.1% (n=1737) had a post-operative transfusion.  Patients receiving a blood transfusion were older, had lower body mass index, and had higher rates of chronic obstructive pulmonary disease (COPD), heart failure, dialysis, prior transfusion, and were more frequently ASA class 3-4 (p<0.001).  Univariate analysis demonstrated that patients requiring transfusion had higher complication rates (4.3% vs. 12.8%, p<0.0001).  Multivariate analysis identified age >70, diabetes, smoking, COPD, prior transfusion, and operative time >2 hours as independent risk factors for transfusion.Conclusion: Among THA patients, characteristics and comorbidities exist that are associated with increased likelihood of transfusion.  Presence of these factors should guide hemoglobin monitoring post-operatively. Selective hemoglobin monitoring can potentially decrease the cost of THA. 

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.

Epidemiological Study of Femoral Head Osteonecrosis

2017 ◽  
Vol 68 (5) ◽  
pp. 974-976
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Victor Grigorescu ◽  
carmen Grierosu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Head Group ◽  
Bipolar Hemiarthroplasty ◽  
Aseptic Necrosis ◽  
Total Hip ◽  
Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

scholarly journals Risk factors in total hip arthroplasty and hemiarthroplasty: Infection and mortality

2021 ◽  
Vol 65 (4) ◽  
pp. 239-247
Author(s):  
A. Hernández-Aceituno ◽  
M. Ruiz-Álvarez ◽  
R. Llorente-Calderón ◽  
P. Portilla-Fernández ◽  
A. Figuerola-Tejerina
Keyword(s):  
Risk Factors ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip
Sign in / Sign up

Export Citation Format

Share Document