Postoperative anemia after joint replacement surgery is not related to quality of life during the first two weeks postoperatively.
BACKGROUND
Lower limb joint replacement surgery provides a considerable improvement in quality of life (QoL), but is associated with peroperative blood loss and with anemia in the direct postoperative period. General acceptance of low transfusion thresholds and shorter postoperative hospital stays will result in patients leaving hospital with low hemoglobin (Hb) levels. To evaluate the role of QoL scores as a possible alternative for Hb values to serve as a further indicator for red blood cell transfusion, we performed a secondary analysis of a previously conducted randomized clinical trial to compare QoL and fatigue scores with simultaneously measured pre- and postoperative Hb levels, in total hip and knee arthroplasty patients.


METHODS
QoL measurement was measured preoperatively and twice up to 14 days postoperatively using the Functional Status Index (FSI), the Visual Analogue Score (VAS)-Fatigue score, and the Functional Assessment of Cancer Therapy Anemia (FACT-Anemia) subscale. Pearson correlation coefficients between (change in) FSI, VAS-Fatigue, and FACT-Anemia subscale scores and (change in) Hb levels were calculated. Additionally, partial correlations were calculated and linear regression analysis was performed, correcting for possible confounding variables.


RESULTS
A total of 603 patients were evaluated. All patients scored worse postoperatively, but none of the scores correlated with Hb values, neither after correcting for confounding factors. Even more, the changes between preoperative and postoperative Hb levels were not correlated with changes in fatigue scores.


CONCLUSIONS
In hip and knee prosthesis surgery no correlation existed between postoperative Hb levels or acute postoperative decline in Hb values and QoL scores (FSI, VAS-Fatigue, or FACT-Anemia).
So-Osman
Cynthia
C
Department of Research and Development, Sanquin Blood Bank South West Region, Leiden, The Netherlands. c.so@sanquin.nl
Nelissen
Rob
R
Brand
Ronald
R
Brand
Anneke
A
Stiggelbout
Anne M
AM
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000503:physiopathology*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors
D006454:Hemoglobins