scholarly journals Modifiable Individual Risks of Perioperative Blood Transfusions and Acute Postoperative Complications in Total Hip and Knee Arthroplasty

2021 ◽  
Vol 11 (11) ◽  
pp. 1223
Author(s):  
Axel Jakuscheit ◽  
Nina Schaefer ◽  
Johannes Roedig ◽  
Martin Luedemann ◽  
Sebastian Philipp von Hertzberg-Boelch ◽  
...  

Background: The primary aim of this study was to identify modifiable patient-related predictors of blood transfusions and perioperative complications in total hip and knee arthroplasty. Individual predictor-adjusted risks can be used to define preoperative treatment thresholds. Methods: We performed this retrospective monocentric study in orthopaedic patients who underwent primary total knee or hip arthroplasty. Multivariate logistic regression models were used to assess the predictive value of patient-related characteristics. Predictor-adjusted individual risks of blood transfusions and the occurrence of any perioperative adverse event were calculated for potentially modifiable risk factors. Results: 3754 patients were included in this study. The overall blood transfusion and complication rates were 4.8% and 6.4%, respectively. Haemoglobin concentration (Hb, p < 0.001), low body mass index (BMI, p < 0.001) and estimated glomerular filtration rate (eGFR, p = 0.004) were the strongest potentially modifiable predictors of a blood transfusion. EGFR (p = 0.001) was the strongest potentially modifiable predictor of a complication. Predictor-adjusted risks of blood transfusions and acute postoperative complications were calculated for Hb and eGFR. Hb = 12.5 g/dL, BMI = 17.6 kg/m2, and eGFR = 54 min/mL were associated, respectively, with a 10% risk of a blood transfusion, eGFR = 59 mL/min was associated with a 10% risk of a complication. Conclusion: The individual risks for blood transfusions and acute postoperative complications are strongly increased in patients with a low preoperative Hb, low BMI or low eGFR. We recommend aiming at a preoperative Hb ≥ 13g/dL, an eGFR ≥ 60 mL/min and to avoid a low BMI. Future studies must show if a preoperative increase of eGFR and BMI is feasible and truly beneficial.

2019 ◽  
Vol 34 (8) ◽  
pp. 1606-1610 ◽  
Author(s):  
Nicole Durig Quinlan ◽  
Dennis Q. Chen ◽  
Brian C. Werner ◽  
C. Lowry Barnes ◽  
James A. Browne

2016 ◽  
Vol 31 (2) ◽  
pp. 378-382 ◽  
Author(s):  
Joshua B. Holt ◽  
Benjamin J. Miller ◽  
John J. Callaghan ◽  
Charles R. Clark ◽  
Melissa D. Willenborg ◽  
...  

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