Risk Factors for Blood Transfusion After Primary Total Hip Arthroplasty

Kyle Kesler, T. Brown, J. R. Martin, B. Springer, Jesse E. Otero
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引用次数: 2

Abstract

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 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.
全髋关节置换术后输血的危险因素
目的:在医疗费用不断上涨的情况下,需要提高全髋关节置换术(THA)的成本效益。THA后,尽管很少有患者需要输血,但大多数患者都接受了连续血红蛋白检测。这种检测增加了成本,对大多数患者来说可能没有必要。本研究旨在确定与输血相关的因素,从而指导THA后的血红蛋白监测。患者和方法:使用国家外科质量改进项目(NSQIP)数据库确定2015年接受原发性THA的患者。手术当天出院的患者除外。患者被分为接受输血和不接受输血的患者。比较各组之间的人口学和合并症,然后进行单变量和多变量分析,从而确定患者特征和与输血相关的合并症。结果:总共确定了28664名接受THA的患者。在这一组中,6.1%(n=1737)接受了术后输血。接受输血的患者年龄较大,体重指数较低,慢性阻塞性肺病(COPD)、心力衰竭、透析、既往输血的发生率较高,更常见的是ASA 3-4级(p 70,糖尿病、吸烟、慢性阻塞性肺病、既往输血和手术时间>2小时是输血的独立危险因素。结论:在THA患者中,存在与输血可能性增加相关的特征和合并症。这些因素的存在应指导术后血红蛋白监测。选择性血红蛋白监测可能降低THA的成本。
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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2
审稿时长
24 weeks
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