Kana Saito1,2, Yu Kaiho2, Toru Tamii1,2,3, Tadaho Nakamura4,5,6, Eri Kameyama1,7, Masanori Yamauchi2. 1. Department of Anesthesia, Tohoku Rosai Hospital, Sendai, Japan. 2. Department of Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. 3. Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan. 4. Department of Anesthesia, Tohoku Rosai Hospital, Sendai, Japan. tadahonakamura@tohoku-mpu.ac.jp. 5. Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan. tadahonakamura@tohoku-mpu.ac.jp. 6. Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan. tadahonakamura@tohoku-mpu.ac.jp. 7. Department of Anesthesia, Minami Soma General Hospital, Minamisōma, Japan.
Abstract
PURPOSE: The amount of intraoperative hemorrhages and factors associated with hemorrhages and transfusions during revision total hip arthroplasty (reTHA) have not been identified for Japanese patients. We aimed to clarify the amount of intraoperative hemorrhages, and to elucidate the factors associated with hemorrhages and transfusions during reTHA in Japanese patients. METHODS: We retrospectively reviewed patients who underwent reTHA (n = 48) and primary total hip arthroplasty (pTHA) (n = 615) in a single hospital and extracted data regarding hemorrhage, transfusion, patient comorbidities, and surgical anesthesia. We defined massive blood loss (MBL) as a hemorrhage comprising more than half of the circulating blood volume within 3 h. The odds ratio (OR) and 95% confidence interval (CI) were estimated using a multivariate logistic regression analysis. RESULTS: There was a significant difference in hemorrhages between reTHA and pTHA patients (1790 g versus 625 g; p < 0.001). Among patients with reTHA, MBL was significantly associated with younger age (OR 0.91; 95% CI 0.84-1.00; p = 0.04) and lower body mass index (BMI) (OR 0.69; 95% CI 0.53-0.91; p = 0.01). Although not significant, the incidence of MBL tended to be higher for patients with hyperlipidemia (OR 4.88; 95% CI 0.99-24.1; p = 0.051). Furthermore, the need for allogeneic transfusion was significantly associated with the number of prepared autologous blood packs (OR 0.15; 95% CI 0.07-0.55; p = 0.002). CONCLUSION: Although this study was limited by its small population and a possibility of underestimating the hemorrhage, hemorrhages in reTHA patients was two times greater than that in pTHA patients. Younger age and lower BMI increased the risk of MBL in reTHA. Preparing autologous blood decreased the risk of intraoperative allogeneic transfusion.
PURPOSE: The amount of intraoperative hemorrhages and factors associated with hemorrhages and transfusions during revision total hip arthroplasty (reTHA) have not been identified for Japanese patients. We aimed to clarify the amount of intraoperative hemorrhages, and to elucidate the factors associated with hemorrhages and transfusions during reTHA in Japanese patients. METHODS: We retrospectively reviewed patients who underwent reTHA (n = 48) and primary total hip arthroplasty (pTHA) (n = 615) in a single hospital and extracted data regarding hemorrhage, transfusion, patient comorbidities, and surgical anesthesia. We defined massive blood loss (MBL) as a hemorrhage comprising more than half of the circulating blood volume within 3 h. The odds ratio (OR) and 95% confidence interval (CI) were estimated using a multivariate logistic regression analysis. RESULTS: There was a significant difference in hemorrhages between reTHA and pTHA patients (1790 g versus 625 g; p < 0.001). Among patients with reTHA, MBL was significantly associated with younger age (OR 0.91; 95% CI 0.84-1.00; p = 0.04) and lower body mass index (BMI) (OR 0.69; 95% CI 0.53-0.91; p = 0.01). Although not significant, the incidence of MBL tended to be higher for patients with hyperlipidemia (OR 4.88; 95% CI 0.99-24.1; p = 0.051). Furthermore, the need for allogeneic transfusion was significantly associated with the number of prepared autologous blood packs (OR 0.15; 95% CI 0.07-0.55; p = 0.002). CONCLUSION: Although this study was limited by its small population and a possibility of underestimating the hemorrhage, hemorrhages in reTHApatients was two times greater than that in pTHA patients. Younger age and lower BMI increased the risk of MBL in reTHA. Preparing autologous blood decreased the risk of intraoperative allogeneic transfusion.
Entities:
Keywords:
Hemorrhage; Revision total hip arthroplasty; Transfusion
Authors: Pearl Toy; Mark A Popovsky; Edward Abraham; Daniel R Ambruso; Leslie G Holness; Patricia M Kopko; Janice G McFarland; Avery B Nathens; Christopher C Silliman; David Stroncek Journal: Crit Care Med Date: 2005-04 Impact factor: 7.598