The incidence and risk factors for allogenic blood transfusion in total knee and hip arthroplasty
The incidence and risk factors for allogenic blood transfusion in total knee and hip arthroplasty
复制标题
全膝髋关节置换术中同种异体输血的发生率及危险因素
DOI：
10.1186/s13018-019-1329-0
复制
发表时间：
2019-08-28
影响因子：
2.6
通讯作者：
Jiang, Qing
中科院分区：
文献类型：
--
作者：
Song, Kai;Pan, Pin;Jiang, Qing
研究背景全关节置换术（total joint arthroplasty，TJA）中失血过多通常导致异体输血，这可能导致不良结局、住院时间延长和费用增加。本研究的目的是确定发生率和风险因素的术中和术后异体输血的患者进行初次单侧全膝关节和髋关节置换术（TKA和THA）。MethodsWe进行了回顾性研究，并纳入连续患者进行初次单侧TKA和THA在我们的机构在2010年1月和2014年7月（n= 1534）。从病历中收集有关异体输血的信息，以确定发生率。我们进行了单因素分析和多因素Logistic回归分析，以确定独立的危险factors.ResultsTotal，术中，术后输血率分别为17.9%，7.9%，和11.3%，分别。术前较低的血红蛋白（Hb）水平（P< 0.001）和术中失血量增加（P< 0.001）与TKA输血独立相关。THA输血的独立危险因素为女性（P= 0.023）、术前Hb水平低（P <0.001）、手术时间延长（P<0.001）和术中失血量增加（P< 0.001）。
BackgroundExcessive blood loss in total joint arthroplasty (TJA) usually leads to an allogenic blood transfusion, which may cause adverse outcomes, prolonged length of hospitalization, and increased costs. The purpose of this study was to determine the incidence and risk factors for intraoperative and postoperative allogenic transfusion in patients undergoing primary unilateral total knee and hip arthroplasty (TKA and THA).MethodsWe conducted a retrospective study and enrolled consecutive patients undergoing primary unilateral TKA and THA at our institution between January 2010 and July 2014 (n= 1534). Information about allogenic transfusion was collected from medical records to determine the incidence. We performed univariate analysis and multivariate logistic regression analysis to identify the independent risk factors.ResultsTotal, intraoperative, and postoperative transfusion rates were 17.9%, 7.9%, and 11.3%, respectively. The preoperative lower level of hemoglobin (Hb) (P< 0.001) and increased amount of intraoperative blood loss (P< 0.001) were independently associated with transfusion in TKA. The independent risk factors for transfusion in THA were female (P= 0.023), preoperative lower Hb level (P< 0.001), prolonged operation time (P< 0.001), and increased intraoperative blood loss (P< 0.001).ConclusionsGiven the high prevalence and potential risk of transfusion in TJA, interventions for identified risk factors should be used during the perioperative period.