Impact of Tibetan ethnicity and residence altitude on complications during total knee arthroplasty and difficulties of measurement of perioperative blood loss

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Wenyu Jiang, Hong Xu, Xing Liu, Huansheng Liu, Yucan Ju, Jinwei Xie, Qiang Huang, Zeyu Huang, Fuxing Pei
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Abstract

Purpose

Tibetan patients undergoing total knee arthroplasty (TKA) have greater fluctuations in perioperative haemoglobin levels and blood hypercoagulability. This study was to investigate whether ethnicity and altitude affect perioperative blood loss and the risk of complications after TKA.

Methods

We retrospectively enrolled 1,116 patients undergoing TKA for knee osteoarthritis at our hospital between January 2016 and September 2021. We divided patients into four groups according to whether they were of Tibetan or Han ethnicity and whether they lived above or below 2500 m above sea level. Primary outcomes were total, intraoperative, and hidden blood losses, while secondary outcomes were complications and homologous transfusion. Factors associated with increased blood loss were analyzed by multivariate regression.

Results

Total blood loss was higher among patients residing at high altitude compared with lower altitude, whether they were of Han (794.6 mL vs. 667.2 mL, P = 0.020) or Tibetan (904.4 mL vs. 663.8 mL, P < 0.001). Total blood loss was similar between the two ethnic groups at the same altitude. Altitude, but not Tibetan ethnicity, remained associated with increased blood loss after being analyzed by multivariate regression. Complications among the four groups were generally similar, although the frequency of calf muscular venous thrombosis was higher among Tibetan patients, while the frequency of blood transfusion was higher among Han subjects.

Conclusions

Our findings indicate that residence at high altitude, but not ethnicity, may contribute to increased total blood loss during TKA. Thrombotic complications were more frequent among Tibetan than Han patients.

Abstract Image

藏族和居住海拔对全膝关节置换术并发症的影响以及围手术期失血量的测量困难
目的接受全膝关节置换术(TKA)的藏族患者围术期血红蛋白水平波动较大,血液高凝状态也较严重。本研究旨在探讨种族和海拔是否会影响 TKA 术后围术期失血量和并发症风险。方法我们回顾性纳入了 2016 年 1 月至 2021 年 9 月期间在我院接受 TKA 术治疗的 1,116 例膝关节骨关节炎患者。我们根据患者是藏族还是汉族以及居住地是海拔 2500 米以上还是以下将其分为四组。主要结果为总失血量、术中失血量和隐性失血量,次要结果为并发症和同源输血量。结果无论是汉族(794.6 mL vs. 667.2 mL,P = 0.020)还是藏族(904.4 mL vs. 663.8 mL,P <0.001),居住在高海拔地区的患者总失血量均高于居住在低海拔地区的患者。在同一海拔高度,两个民族的总失血量相似。经多元回归分析,海拔(而非藏族)仍与失血量增加有关。尽管藏族患者小腿肌肉静脉血栓形成的频率较高,而汉族受试者输血的频率较高,但四组受试者的并发症基本相似。藏族患者的血栓并发症发生率高于汉族患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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