title: Behaviour of perioperative values of haemoglobin, haematocrit and red blood cells in elderly patients undergoing lower limb arthroplasty: a retrospective cohort study on non-transfused patients.
abstract: Little is known on how elderly patients recover pre-operative haemoglobin, haematocrit and red blood cell levels after total hip and knee arthroplasties. In this study we aimed to evaluate blood loss and recovery blood levels in relation to gender, type of surgery and preoperative haemoglobin values. We conducted a retrospective cohort study on 187 patients over 65 years of age who underwent total knee or total hip arthroplasty between January 2008 and December 2009. Preoperative blood analysis was carried out within 40 days prior to intervention followed by a 15-day postoperative follow-up. Haemoglobin recovery values in anaemic patients versus healthy patients was also estimated. All tested values decreased significantly during the first 3-5 postoperative days. Haemoglobin levels decreased statistically significantly more in males than in females, while no significant differences were observed for haematocrit and erythrocytes. Recovery of haemoglobin values did not differ significantly between healthy patients and patients with preoperative haemoglobin below 120 g/L. Furthermore, our data showed a higher blood loss in total hip arthroplasty, whilst recovery rates showed to be higher after a total knee arthroplasty procedure. In conclusion, the type of intervention and gender played an important role in blood loss and recovery rates in total joint arthroplasty.
authors.affiliation: Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Institute, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Drago
authors.forename: E
authors.initials: E
authors.lastname: De Vecchi
authors.forename: C L
authors.initials: CL
authors.lastname: Romano'
authors.forename: C
authors.initials: C
authors.lastname: Vassena
authors.forename: G
authors.initials: G
authors.lastname: Banfi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D016063:Blood Loss, Surgical; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D059035:Perioperative Period; D019106:Postoperative Hemorrhage / Q000097:blood / Q000209:etiology; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006454:Hemoglobins