Abstract
There is an increasing body of evidence that allogenic blood transfusion is harmful and blood itself is a valuable resource not to be dispensed lightly. Therefore, a review was undertaken into the need for allogenic blood transfusion following primary unilateral hip arthroplasty in our unit. An initial audit was performed retrospectively on 191 consecutive patients, revealing that 73 of the 191 (38%) received allogenic blood either intra-operatively or postoperatively. Guidelines were drawn up, then implemented, with the assisistance of the anaesthetic and haematology departments. The threshold for transfusion was a post-operative haemoglobin of less than 8g/dL. A trial period of 2 months was used to study the impact of these guidelines. No patients were excluded at the outset due to age or co-morbidity. During this period 96 patients were identified for inclusion in the study, of which only 19 (20%) required blood transfusion. In order to ensure these guidelines were not unsafe we compared the length of hospital stay following surgery in both groups of patients as a surrogate measure of postoperative complications. There was no significant difference between the lengths of stay in each groups. The conclusion was drawn that these new guidelines are not detrimental to the patient, and roughly halve the need for allogenic blood transfusion.
Editoral Secretary Mr Peter Howard. Correspondence should be addressed to BHS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN.
