Baseline hemoglobin as a predictor of risk of transfusion and response to Epoetin alfa in orthopedic surgery patients.
A multicenter, double-blind, placebo-controlled, parallel-group study was undertaken to determine whether Epoetin alfa can reduce perioperative transfusion requirements. Twenty-six medical centers enrolled 316 patients who were scheduled for major orthopedic surgery and were expected to require > or = 2 units of blood. Patients were stratified according to baseline hemoglobin levels and randomly assigned to receive either Epoetin alfa (300 IU/kg or 100 IU/kg) or placebo for 15 consecutive days starting 10 days prior to, on the day of, and for 4 days after surgery. Epoetin alfa (300 IU/kg) resulted in significantly less exposure to allogeneic blood transfusion compared with placebo (16%) versus 45%) in patients whose baseline hemoglobin level was > 10 to < or = 13 g/dL (P = 0.024). Mean number of units transfused per patient was also lower among those treated with Epoetin alfa (overall, P = 0.027). Epoetin alfa was safe and well tolerated in this population.
de Andrade
J R
JR
Emory University School of Medicine, Atlanta, Georgia, USA.
Jove
M
M
Landon
G
G
Frei
D
D
Guilfoyle
M
M
Young
D C
DC
D000368:Aged; D016063:Blood Loss, Surgical / Q000503:physiopathology*; D001803:Blood Transfusion; D004311:Double-Blind Method; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000009:adverse effects / Q000627:therapeutic use*; D006400:Hematocrit; D006452:Hemoglobinometry; D006615:Hip / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D007717:Knee / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D011183:Postoperative Complications; D011300:Preoperative Care; D011994:Recombinant Proteins; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology
D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa