title: Predictors and complications of blood transfusion in total hip and knee arthroplasty.
abstract: Perioperative patient optimization can minimize the need for blood transfusions in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to determine predictors and complications of transfusions. This retrospective review analyzed 1795 patients who underwent primary THA and TKA at our institution between January 2011 and December 2012. Of the 1573 patients ultimately included the rates of transfusion were 9.27% in TKA and 26.6% in THA. Significant predictors for transfusion include: preoperative hemoglobin, age, female gender, body mass index, creatinine, TKA, operating room time, operative blood loss, and intra-operative fluids. The DVT rate was comparable, but deep surgical site infection rate among transfused patients was 2.4% compared to 0.5% in non-transfused patients (P = 0.0065).
authors.affiliation: Henry Ford Health System Department of Orthopaedic Surgery, Detroit, Michigan.
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Frisch
authors.affiliation: Henry Ford Health System Department of Orthopaedic Surgery, Detroit, Michigan.
authors.forename: Nolan M
authors.initials: NM
authors.lastname: Wessell
authors.affiliation: Henry Ford Health System Department of Orthopaedic Surgery, Detroit, Michigan.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Charters
authors.affiliation: Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Stephen
authors.initials: S
authors.lastname: Yu
authors.affiliation: Henry Ford Health System Department of Internal Medicine, Detroit, Michigan.
authors.forename: James J
authors.initials: JJ
authors.lastname: Jeffries
authors.affiliation: Henry Ford Health System Department of Orthopaedic Surgery, Detroit, Michigan.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Silverton
mesh_terms: D000367:Age Factors; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013530:Surgical Wound Infection; D065227:Transfusion Reaction
chemical_list: D006454:Hemoglobins; D003404:Creatinine
keywords: blood management; complications; total hip arthroplasty; total knee arthroplasty; transfusion