Dominik Malcherczyk1, Juliane Hack2, Antonio Klasan2, Asma Abdelmoula2, Thomas J Heyse2, Brandon Greene3, Bilal F El-Zayat2. 1. Center for Orthopedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany. malcherc@med.uni-marburg.de. 2. Center for Orthopedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany. 3. Institute of Medical Biometry and Epidemiology, University Marburg, Bunsenstraße 3, 35037, Marburg, Germany.
Abstract
PURPOSE: In this study, the total blood loss, transfusion rate and number of transfused blood units in patients with different indications for shoulder arthroplasty: primary, fracture and secondary were compared. Risk factors for bleeding and transfusion were analysed. METHODS: Medical records and the database of the institution's blood bank from 527 patients that received shoulder arthroplasty were analysed retrospectively. This study included 419 patients that were divided in three different groups: primary (n = 278), fracture (n = 110) and secondary (following prior osteosynthesis; n = 31) shoulder arthroplasty. The demographic and clinical data were collected. The total blood loss (TBL) was calculated and transfusions recorded. RESULTS: The transfusion rate and mean amount of transfused blood units (BU) were higher in fracture (32.7% and 0.69BU, p < 0.01) and secondary arthroplasty (35.5% and 0.97BU, p < 0.01) than in primary arthroplasty (12.6% and 0.28BU). The overall transfusion rate was 19.6% at a mean TBL of 370 ml. However, patients with primary arthroplasty experienced significantly higher total blood loss than those after fracture arthroplasty (p < 0.01). Longer surgery time and male sex are significant risk factors for elevated blood loss. The pre-operative use of vitamin K antagonist, cemented arthroplasty, high BMI, coronary heart disease and ASA score > 2 are relevant risk factors for blood transfusion. CONCLUSION: The most important susceptible factor that affects the TBL is the surgery time. Transfusion rates are higher in patients with fracture arthroplasty than after primary arthroplasty.
PURPOSE: In this study, the total blood loss, transfusion rate and number of transfused blood units in patients with different indications for shoulder arthroplasty: primary, fracture and secondary were compared. Risk factors for bleeding and transfusion were analysed. METHODS: Medical records and the database of the institution's blood bank from 527 patients that received shoulder arthroplasty were analysed retrospectively. This study included 419 patients that were divided in three different groups: primary (n = 278), fracture (n = 110) and secondary (following prior osteosynthesis; n = 31) shoulder arthroplasty. The demographic and clinical data were collected. The total blood loss (TBL) was calculated and transfusions recorded. RESULTS: The transfusion rate and mean amount of transfused blood units (BU) were higher in fracture (32.7% and 0.69BU, p < 0.01) and secondary arthroplasty (35.5% and 0.97BU, p < 0.01) than in primary arthroplasty (12.6% and 0.28BU). The overall transfusion rate was 19.6% at a mean TBL of 370 ml. However, patients with primary arthroplasty experienced significantly higher total blood loss than those after fracture arthroplasty (p < 0.01). Longer surgery time and male sex are significant risk factors for elevated blood loss. The pre-operative use of vitamin K antagonist, cemented arthroplasty, high BMI, coronary heart disease and ASA score > 2 are relevant risk factors for blood transfusion. CONCLUSION: The most important susceptible factor that affects the TBL is the surgery time. Transfusion rates are higher in patients with fracture arthroplasty than after primary arthroplasty.
Entities:
Keywords:
Bleeding; Blood transfusion; Fracture; Primary; Primary arthroplasty; Secondary; Shoulder arthroplasty; Shoulder endoprosthesis; Total blood loss
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