Jiahao Li1, Yijin Li1, Yiwei Huang1, Haitao Zhang2, Pengcheng Ye3, Peng Deng4, Jinlun Chen3, Jie Li3, Xinyu Qi3, Jianchun Zeng3, Wenjun Feng3, Yirong Zeng5. 1. The First Clinical Medical College, Guangzhou University of Chinese Medicine, Jichang Road 12#, Baiyun District, Guangzhou, 510405, Guangdong Province, China. 2. Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China. 3. Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, Baiyun District, Guangzhou, 510405, Guangdong Province, China. 4. Department of Orthopedics, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China. 5. Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Jichang Road 16#, Baiyun District, Guangzhou, 510405, Guangdong Province, China. zeng1466@126.com.
Abstract
PURPOSE: Our research investigated predictors of postoperative blood transfusion rate following total joint arthroplasty (TJA) in patients with rheumatoid arthritis (RA) and evaluated the incidence of complications in the transfusion group and non-transfusion group. METHODS: The authors retrospectively analyzed risk factors among 320 RA patients who underwent elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) from January 2010 to December 2018. Demographic characteristics, laboratory results, medication history, and surgical protocol were gathered from electronic medical records. Univariable and multivariable logistic regression analyses were conducted to measure the impact of relevant variables on the need for transfusions. In addition, we compared the incidence of complications associated with transfusion. RESULTS: The cohort comprised 320 RA patients, aged 57.4 ± 12.0 years, of whom 137 required postoperative blood transfusions and 183 did not. BMI, type of surgery, duration of surgery, disease activity score 28 (DAS28-CRP), tranexamic acid (TXA) administration, and preoperative hemoglobin (Hb) were all risk factors for transfusion after adjusting for the planned procedure. CONCLUSION: Previously published predictors, such as BMI, low preoperative hemoglobin, duration of surgery, procedure type (THA), were also identified in our analysis. Moreover, TXA administration and the DAS28-CRP showed the potential to influence risk. The incidence of postoperative complications was increased in patients who received blood transfusions compared to non-transfusion group. Our findings could help to identify RA patient population requiring blood transfusions, to ensure the necessary steps are adopted to limit blood loss and improve blood management strategies. Key Points • The risk factors for blood transfusion in rheumatoid arthritis patients undergoing total joint arthroplasty were BMI, the type of surgery, duration of surgery, TXA administration, DAS28-CRP, and preoperative hemoglobin. • The incidence of postoperative complications was increased in patients who received blood transfusions compared to non-transfusion group.
PURPOSE: Our research investigated predictors of postoperative blood transfusion rate following total joint arthroplasty (TJA) in patients with rheumatoid arthritis (RA) and evaluated the incidence of complications in the transfusion group and non-transfusion group. METHODS: The authors retrospectively analyzed risk factors among 320 RA patients who underwent elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) from January 2010 to December 2018. Demographic characteristics, laboratory results, medication history, and surgical protocol were gathered from electronic medical records. Univariable and multivariable logistic regression analyses were conducted to measure the impact of relevant variables on the need for transfusions. In addition, we compared the incidence of complications associated with transfusion. RESULTS: The cohort comprised 320 RA patients, aged 57.4 ± 12.0 years, of whom 137 required postoperative blood transfusions and 183 did not. BMI, type of surgery, duration of surgery, disease activity score 28 (DAS28-CRP), tranexamic acid (TXA) administration, and preoperative hemoglobin (Hb) were all risk factors for transfusion after adjusting for the planned procedure. CONCLUSION: Previously published predictors, such as BMI, low preoperative hemoglobin, duration of surgery, procedure type (THA), were also identified in our analysis. Moreover, TXA administration and the DAS28-CRP showed the potential to influence risk. The incidence of postoperative complications was increased in patients who received blood transfusions compared to non-transfusion group. Our findings could help to identify RA patient population requiring blood transfusions, to ensure the necessary steps are adopted to limit blood loss and improve blood management strategies. Key Points • The risk factors for blood transfusion in rheumatoid arthritis patients undergoing total joint arthroplasty were BMI, the type of surgery, duration of surgery, TXA administration, DAS28-CRP, and preoperative hemoglobin. • The incidence of postoperative complications was increased in patients who received blood transfusions compared to non-transfusion group.
Authors: Jeffrey L Carson; Simon J Stanworth; Jane A Dennis; Marialena Trivella; Nareg Roubinian; Dean A Fergusson; Darrell Triulzi; Carolyn Dorée; Paul C Hébert Journal: Cochrane Database Syst Rev Date: 2021-12-21
Authors: Chenglong Han; Mahboob U Rahman; Mittie K Doyle; Joan M Bathon; Josef Smolen; Arthur Kavanaugh; René Westhovens; E William St Clair; Daniel Baker; Mohan Bala Journal: J Rheumatol Date: 2007-10-15 Impact factor: 4.666