title: Comparison of restrictive and liberal transfusion strategy on postoperative delirium in aged patients following total hip replacement: a preliminary study.
abstract: Few studies have examined the association between perioperative blood transfusion and postoperative delirium (POD) in aged patients undergoing total hip replacement surgery. In this prospective study, 186 patients older than 65 years undergoing elective unilateral total hip replacement surgery were enrolled. Of those, 94 patients were randomly assigned to the restrictive strategy transfusion strategy group, in which red blood cells were transfused in order to maintain 10.0 g/dL>hemoglobin≧8.0 g/dL. Ninety-two patients were randomly assigned to the liberal transfusion strategy group, in which red blood cells were transfused in order to maintain hemoglobin≧10.0 g/dL. POD was diagnosed by confusion assessment method. The baseline characteristics of patients, the length of hospital stay, the incidence of POD, myocardial infarction, stroke, wound infection, pulmonary embolism, and the transfusion volume were recorded. No difference was observed in the baseline characteristics, the length of hospital stay, and the incidence of POD, myocardial infarction, stroke, wound infection, and pulmonary embolism between the two groups (P>0.05). The proportion of patients transfused with red blood cell and frozen plasma was decreased in the restrictive transfusion group compared with the liberal transfusion group (P<0.05). In conclusion, restrictive transfusion does not influence the incidence of POD but reduces blood transfusion. Thus, restrictive transfusion may serve as an effective and safe strategy for aged patients following total hip replacement.
authors.affiliation: Department of Anesthesiology and Intensive Care, Jintan Hospital, Jiangsu University, Changzhou, China.
authors.forename: Yun-Xia
authors.initials: YX
authors.lastname: Fan
authors.affiliation: Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China.
authors.forename: Fang-Fang
authors.initials: FF
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China.
authors.forename: Min
authors.initials: M
authors.lastname: Jia
authors.affiliation: Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China.
authors.forename: Jiao-Jiao
authors.initials: JJ
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China.
authors.forename: Jin-Chun
authors.initials: JC
authors.lastname: Shen
authors.affiliation: Department of Anesthesiology and Intensive Care, Jintan Hospital, Jiangsu University, Changzhou, China.
authors.forename: Guang-Ming
authors.initials: GM
authors.lastname: Zhu
authors.affiliation: Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China.
authors.forename: Si-Hai
authors.initials: SH
authors.lastname: Zhu
authors.affiliation: Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China.
authors.forename: Wei-Yan
authors.initials: WY
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China. Electronic address: jimuhuo2009@sina.com.
authors.forename: Mu-Huo
authors.initials: MH
authors.lastname: Ji
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D015415:Biomarkers / Q000097:blood; D003693:Delirium / Q000097:blood / Q000453:epidemiology*; D017558:Elective Surgical Procedures; D017707:Erythrocyte Transfusion / Q000379:methods*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D006454:Hemoglobins
keywords: Inflammatory response; Liberal transfusion; Postoperative cognitive delirium; Restrictive transfusion