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Multicenter Study
. 2014 Jan 21:2014:623460.
doi: 10.1155/2014/623460. eCollection 2014.

Blood transfusions in total hip and knee arthroplasty: an analysis of outcomes

Thomas Danninger  1 , Rehana Rasul  2 , Jashvant Poeran  2 , Ottokar Stundner  3 , Madhu Mazumdar  2 , Peter M Fleischut  4 , Lazaros Poultsides  5 , Stavros G Memtsoudis  1
Affiliations
Multicenter Study

Blood transfusions in total hip and knee arthroplasty: an analysis of outcomes

Thomas Danninger et al. ScientificWorldJournal. .

Abstract

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.

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References

    1. Möhnle P, Snyder-Ramos SA, Miao Y, et al. Postoperative red blood cell transfusion and morbid outcome in uncomplicated cardiac surgery patients. Intensive Care Medicine. 2011;37(1):97–109. - PubMed
    1. Scott BH, Seifert FC, Grimson R. Blood transfusion is associated with increased resource utilisation, morbidity and mortality in Cardiac Surgery. Annals of Cardiac Anaesthesia. 2008;11(1):15–19. - PubMed
    1. Vamvakas EC, Carven JH. RBC transfusion and postoperative length of stay in the hospital or the intensive care unit among patients undergoing coronary artery bypass graft surgery: The effects of confounding factors. Transfusion. 2000;40(7):832–839. - PubMed
    1. Kuduvalli M, Oo AY, Newall N, et al. Effect of peri-operative red blood cell transfusion on 30-day and 1-year mortality following coronary artery bypass surgery. European Journal of Cardio-thoracic Surgery. 2005;27(4):592–598. - PubMed
    1. Hopewell S, Omar O, Hyde C, Yu LM, Doree C, Murphy MF. A systematic review of the effect of red blood cell transfusion on mortality: evidence from large-scale observational studies published between 2006 and 2010. British Medical Journal Open. 2013;3(5)002154 - PMC - PubMed

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