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EVIDENCE-BASED APPROACH TO TRANSFUSION IN ARTHROPLASTY SURGERY



Abstract

Purpose: To determine predictive factors for alloge-neic blood transfusion to aid in development of blood conservation strategies for the Hamilton arthroplasty population

Methods: A prospectively collected, retrospective study of 828 patients, who did not donate blood, treated with either primary total knee or total hip arthroplasty from 1998 to 2002 at Hamilton Henderson Hospital was carried out. A univariate analysis was performed to establish the relationship between all independent variables and the need for postoperative transfusion. Variables that were determined to have a significant relationship were included in a multivariate analysis

Results: The univariate analysis revealed a significant relationship between the need for postoperative blood transfusion and preoperative hemoglobin levels (p=0.000), age (P=0.000), and gender (P=0.005). However, the multivariate analysis only revealed significant relationship between the need for transfusion and pre-operative hemoglobin (P=0.000) and age (P=0.014). Patients with preoperative hemoglobin of > 150 g/L had a 10% risk of transfusion. Patients with preoperative hemoglobin of 141–150 g/L has 2.5 times greater risk, 131–140 g/L 4 times greater risk, 121–130 g/L 6 times greater risk, and < 120 25 times greater risk than patients with preoperative hemoglobin > 150 g/L.

Conclusions: The preoperative hemoglobin level and age were shown to predict the need for blood transfusion after total joint arthroplasty. These results of this will help to create guidelines for the Blood Conservation Program in HHSC.

Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada