scholarly journals Effect of an Elevated Preoperative International Normalized Ratio on Transfusion and Complications in Primary Total Hip Arthroplasty with the Enhanced Recovery after Surgery Protocol

2021 ◽  
Author(s):  
Linbo Peng ◽  
Junfeng Zeng ◽  
Yi Zeng ◽  
Yuangang Wu ◽  
Jing Yang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
International Normalized Ratio ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

scholarly journals Preoperative Elevated International Normalized Ratio Cannot Increase Transfusion or Complication in Primary Total Hip Arthroplasty: A Retrospective Study of 552 Cases

2020 ◽  
Author(s):  
Linbo Peng ◽  
Junfeng Zeng ◽  
Yi Zeng ◽  
Yuangang Wu ◽  
Jing Yang ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Complication Rate ◽  
Binary Logistic Regression ◽  
International Normalized Ratio ◽  
Transfusion Rate ◽  
Total Hip ◽  
Significant Difference ◽  
Loss Maximum ◽  
Primary Total Hip Arthroplasty

Abstract Background: Verify if the elevated preoperative International Normalized Ratio (INR) can increase transfusion and complication rate in primary total hip arthroplasty.Methods: We retrospectively reviewed the database of adults who underwent primary total hip arthroplasty between 2014 to 2018 by the same surgeon. 552 cases were assigned into 3 groups by preoperative INR class: INR≤0.9, 0.9＜INR＜1.0, and INR≥1.0 eventually. We regarded the transfusion rate as the primary outcome. We also included perioperative blood loss, maximum Hb-drop, postoperative anemia needs medicine, length of stay (LOS), re-operation, the complication rate in 90 days and mortality as the secondary outcomes. Univariable analyses were utilized to compare baselines and outcomes between groups. Binary Logistic Regression was used to adjust differences of baselines among groups.Results: All the cases had an INR＜1.5. Among all the cases, 93(16.8%) had INR≤0.9, 268 (48.6%) had 0.9＜INR＜1.0, and 191 (34.6%) had INR≥1.0, respectively. In the univariable analyses, with the INR elevated, The transfusion rates increased from 1.08% for INR≤0.9, 1.12% for 0.9＜INR＜1.0 to 5.76% for INR≥1.0 (p＜0.05). The overall complication rate increased from 10.8% for INR≤0.9, 16.4% for 0.9＜INR＜1.0 to 22.5% for INR≥1.0 (p＜0.05). When controlling for the demographics and comorbidities characteristics, there was no statistically significant difference when evaluating the odds of transfusion nor overall complication rate between the groups (p＞0.05).Conclusions: The transfusion and complication rate cannot increase along with the INR elevated in primary THA. With the improvement of arthroplasty protocol and use of tranexamic acid, the INR＜1.5 was still a conventional safe threshold.

scholarly journals Limited Influence of Comorbidities on Length of Stay after Total Hip Arthroplasty: Experience of Enhanced Recovery after Surgery

2019 ◽  
Vol 12 (1) ◽  
pp. 153-161 ◽  
Author(s):  
Zi‐chuan Ding ◽  
Bing Xu ◽  
Zhi‐min Liang ◽  
Hao‐yang Wang ◽  
Ze‐yu Luo ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Length Of Stay ◽  
Hip Arthroplasty ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Total Hip
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