title: Postoperative autotransfusion drain after total hip arthroplasty: a meta-analysis of randomized controlled trials.
abstract: The use of a postoperative autotransfusion drain (PATD) to reduce allogenic blood transfusions in total hip arthroplasty (THA) remains controversial. Therefore, we conducted a meta-analysis to evaluate the efficacy and safety of this technique. Randomized controlled trials (RCTs) were identified from PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL). Thirteen RCTs (1,424 participants) were included in our meta-analysis. The results showed that PATD reduced the rate of allogenic transfusions (RR = 0.56; 95% CI [0.40, 0.77]) and total blood loss (MD = -196.04; 95% CI [-311.01, -81.07]). Haemoglobin (Hb) levels were higher in the PATD group on postoperative day 1 (MD = 0.28; 95% CI [0.06, 0.49]), but no significant differences on postoperative days 2 or 3 (MD = 0.29; 95% CI [-0.02, 0.60]; MD = 0.26; 95% CI [-0.04, 0.56]; respectively). There were no differences in length of hospital stay (MD = -0.18; 95% CI [-0.61, 0.25]), febrile reaction (RR = 1.26; 95% CI [0.95, 1.67]), infection (RR = 0.95; 95% CI [0.54, 1.65]), wound problems (RR = 1.07; 95% CI [0.87, 1.33]), or serious adverse events (RR = 0.59; 95% CI [0.10, 3.58]). Our findings suggest that PATD is effective in reducing the rate of allogenic transfusion. However, the included studies are inadequately powered to conclusively determine the safety of this technique.
authors.affiliation: Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Xie
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, China.
authors.forename: Jian-Ke
authors.initials: JK
authors.lastname: Pan
authors.affiliation: Department of Orthopaedics, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou 510095, China.
authors.forename: Kun-Hao
authors.initials: KH
authors.lastname: Hong
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, China.
authors.forename: Da
authors.initials: D
authors.lastname: Guo
authors.affiliation: Department of Orthopaedics, Third Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510375, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Fang
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, China.
authors.forename: Wei-Yi
authors.initials: WY
authors.lastname: Yang
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000379:methods*; D004322:Drainage; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic
chemical_list: D006454:Hemoglobins