SSRIs increase risk of blood transfusion in patients admitted for hip surgery.
BACKGROUND
Recent studies have shown that an increased bleeding tendency can be caused by Selective Serotonin Reuptake Inhibitors (SSRI) use. We aimed to investigate the occurrence and risk of blood transfusion in SSRI users compared to non-SSRI users in a cohort of patients admitted for hip-surgery.


METHODS
We conducted a retrospective cohort study of patients who underwent planned or emergency hip surgery from 1996 to 2011 in the Academic Medical Center in Amsterdam. Primary outcome measure was risk of blood transfusion. Secondary outcome measures were pre- and postoperative hemoglobin level. Multivariate logistic regression was used to adjust for potential confounders.


RESULTS
One-hundred and fourteen SSRI users were compared to 1773 non-SSRI users. Risk of blood transfusion during admission was increased for SSRI users in multivariate analyses (OR 1.7 [95% CI 1.1-2.5]). Also, pre-operative hemoglobin levels were lower in SSRI users (7.8 ± 1.0 mmol/L) compared to non-SSRI users (8.0 ± 1.0 mmol/L) (p  =  0.042)), as were postoperative hemoglobin levels (6.2 ± 1.0 mmol/L vs. 6.4 ± 1.0 mmol/L respectively) (p  =  0.017)).


CONCLUSIONS
SSRI users undergoing hip surgery have an increased risk for blood transfusion during admission, potentially explained by a lower hemoglobin level before surgery. SSRI use should be considered as a potential risk indicator for increased blood loss in patients admitted for hip surgery. These results need to be confirmed in a prospective study.
Section of Geriatric Medicine, Department of Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Hermien Janneke
HJ
Schutte
Section of Geriatric Medicine, Department of Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Sofie
S
Jansen
Department of Orthopedic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Matthias U
MU
Schafroth
Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
J Carel
JC
Goslings
Section of Geriatric Medicine, Department of Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Nathalie
N
van der Velde
Section of Geriatric Medicine, Department of Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Sophia E J A
SE
de Rooij
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D005260:Female; D006615:Hip / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced* / Q000628:therapy; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
D017367:Selective Serotonin Reuptake Inhibitors