title: Revision total hip replacement: predictors of blood loss, transfusion requirements, and length of hospitalisation.
abstract: BACKGROUND
  Revision total hip replacement (THR) is associated with increased blood loss and extended hospitalization.
  
  
  METHODS
  We reviewed 146 patients who underwent revision THR to identify predictors of blood loss, transfusion requirements, and length of hospitalization.
  
  
  RESULTS
  Blood loss was greater with increasing age and in men. Femoral and dual-component revision and revision of cemented hip components were also associated with greater blood loss. Transfusion requirements were greater in patients who had lower preoperative hemoglobin concentration and in patients undergoing dual-component revision. Length of hospitalization was significantly increased in patients who received transfusion but less in patients who underwent isolated acetabular-component hip revision.
  
  
  CONCLUSIONS
  This study shows significantly greater blood loss in men, older patients, revision surgery of cemented implants, and dual-component revisions. More complex revision surgery and preoperative anemia are clearly associated with increased transfusion requirements and length of hospitalization. Identification and treatment of patients at higher risk of transfusion may guide likely transfusion requirements, shorten the length of hospitalization, and reduce the overall cost of treatment.
authors.affiliation: SPR Trauma and Orthopaedics, University Hospitals of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK. m.deven@gmail.com
authors.forename: Devendra
authors.initials: D
authors.lastname: Mahadevan
authors.forename: Christopher
authors.initials: C
authors.lastname: Challand
authors.forename: Jonathan
authors.initials: J
authors.lastname: Keenan
mesh_terms: D017677:Age Distribution; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D016063:Blood Loss, Surgical / Q000503:physiopathology / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011475:Prosthesis Failure; D012044:Regression Analysis; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom