title: [Factors associated with blood transfusion during anesthesia for scheduled hip or knee arthroplasty in France].
abstract: OBJECTIVE
  To determine over a whole country what are the factors associated with an intraoperative homologous blood transfusion and with the use of autologous techniques (preoperative autologous blood donation: PABD; acute normovolemic hemodilution: ANVH; intraoperative red cell salvage: IRCS).
  
  
  METHODS
  National enquiry using a large representative sample (3 days of anaesthesia in France).
  
  
  METHODS
  Univariate followed by multivariate analyses of data gathered in 1996 during the survey leaded by the French society of anaesthesia and intensive care (Sfar) and corresponding to 884 scheduled hip and knee prosthesis surgical procedures.
  
  
  RESULTS
  Factors associated with a decreased use of PABD programme were: 1--old age and high ASA physical status; 2--procedures of short duration. By contrast, an increased use of PABD was associated with anaesthetics in which a closed circuit had been used. Except for a significant association with increasing age and with absence of PABD used, no additional factor was found to be linked with ANVH. No factor among those studied was found related to the use of IRCS. Homologous blood transfusion was more frequently used in ASA > or = 3 patients, in long duration surgeries while its use was decreased in patients with PABD (odds ratio--for reduction by PABD: 4.4 [95% confidence interval: 2.2-8.8]). Homologous blood transfusion was not related to the use of ANVH or IRCS.
  
  
  CONCLUSIONS
  These data obtained from a large national survey confirm previously published studies and meta-analyses and are in agreement with current recommendations. An unexpected relation between PABD and closed circuit anaesthesia has been found.
authors.affiliation: Service d'anesthésie-réanimation, centre hospitalier universitaire Saint-Antoine, 75012 Paris, France. andre.lienhart@sat.ap-hop-paris.fr
authors.forename: A
authors.initials: A
authors.lastname: Lienhart
authors.forename: F
authors.initials: F
authors.lastname: Péquignot
authors.forename: Y
authors.initials: Y
authors.lastname: Auroy
authors.forename: D
authors.initials: D
authors.lastname: Benhamou
authors.forename: F
authors.initials: F
authors.lastname: Clergue
authors.forename: M C
authors.initials: MC
authors.lastname: Laxenaire
authors.forename: E
authors.initials: E
authors.lastname: Jougla
mesh_terms: D000368:Aged; D000758:Anesthesia; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006438:Hemodilution / Q000706:statistics & numerical data; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis