Blood management in total hip replacement: an analysis of factors associated with allogenic blood transfusion.

Abstract:

BACKGROUND:The aim of this study was to audit the blood transfusion practice throughout the Epworth Healthcare Hospitals for patients undergoing primary total hip replacement (THR). We determined if blood-saving techniques were having an impact on the risk of allogenic blood transfusion and which patients were at risk of receiving allogenic blood transfusion. METHODS:This study uses a retrospective audit of 787 patients who had undergone primary THR surgery at three Melbourne hospitals: Epworth Richmond, Epworth Eastern and Epworth Freemasons in 2010. Patient demographics, transfusion requirements and blood-conserving techniques were recorded. RESULTS:One hundred and eighty (23%) patients received allogenic blood transfusion and 18 (2.3%) patients received autologous blood transfusion. On multivariate analysis, preoperative anaemia (odds ratio (OR) 4.7, P < 0.0001), female gender (OR 3.1, P < 0.0001) and patient age (OR 1.07 per year of age increase, P < 0.0001) were shown to be significantly associated with higher risk of allogenic blood transfusion. Use of spinal anaesthetic was found to be associated with lower risk of transfusion (OR 0.6, P = 0.0180) compared with general anaesthetic alone. Cell saver, acute normovolaemic haemodilution and re-infusion drain tube usage did not have a significant impact on reducing the risk of allogenic blood transfusion. CONCLUSION:Identification of patients at risk of blood transfusion, correction of preoperative anaemia and a restrictive transfusion policy are important factors to consider in effective perioperative blood management.

journal_name

ANZ J Surg

journal_title

ANZ journal of surgery

authors

Wong S,Tang H,de Steiger R

doi

10.1111/ans.13048

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

461-5

issue

6

eissn

1445-1433

issn

1445-2197

journal_volume

85

pub_type

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