Journal article
Who Is Still Receiving Blood Transfusions After Primary and Revision Total Joint Arthroplasty?
The Journal of arthroplasty, Vol.37(6S), pp.S63-S69.e1
06/01/2022
DOI: 10.1016/j.arth.2021.08.018
PMID: 34511282
Abstract
Incidence of blood transfusions after primary and revision total hip and knee arthroplasty (primary total hip arthroplasty [pTHA], revision THA [rTHA], primary total knee arthroplasty [pTKA], and revision TKA [rTKA]) has been decreasing for a multitude of reasons. The purpose of this study was to assess whether transfusion rates have continued to decline and evaluate patient factors associated with transfusions.
The American College of Surgeons National Surgical Quality Improvement Program was queried to identify patients undergoing pTHA, pTKA, rTHA, and rTKA between 2011 and 2019. Patients undergoing bilateral procedures and arthroplasty for fracture, infection, or tumor were excluded. Trends in blood transfusions were assessed. Patient factor association with blood transfusions was evaluated using 2018 and 2019 data.
Transfusion rates decreased from 21.4% in 2011 to 2.5% in 2019 for pTHA (P < .0001). For pTKA, transfusion rates declined from 17.6% to 0.7% (P < .0001). In rTHA, the transfusion rate decreased from 33.5% to 12.0% from 2011 to 2019 (P < .0001). Transfusion rates declined from 19.4% to 2.6% for rTKA during the study period (P < .0001). Transfusions were more frequent in patients who were older, female, with more comorbidities, with lower hematocrit, receiving nonspinal anesthesia, and with longer operative time. Lower preoperative hematocrit, history of bleeding disorders, and preoperative transfusion were associated with greater odds for postoperative transfusion after multivariate analysis.
Transfusions after both primary and revision total joint arthroplasty have continued to decrease. Studies of arthroplasty complications should account for decreasing transfusions when assessing overall complication rates. Future studies should consider interventions to further reduce transfusions in revision arthroplasty.
Details
- Title: Subtitle
- Who Is Still Receiving Blood Transfusions After Primary and Revision Total Joint Arthroplasty?
- Creators
- David E DeMik - University of IowaChristopher N Carender - University of IowaNatalie A Glass - University of IowaTimothy S Brown - University of IowaJohn J Callaghan - University of IowaNicholas A Bedard - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.37(6S), pp.S63-S69.e1
- DOI
- 10.1016/j.arth.2021.08.018
- PMID
- 34511282
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Language
- English
- Date published
- 06/01/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation
- Record Identifier
- 9984548671502771
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