Section of Surgical Pathophysiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark.
Vox Sang. 2011 May;100(4):374-80. doi: 10.1111/j.1423-0410.2010.01428.x. Epub 2010 Oct 28.
The optimal transfusion strategy in hip arthroplasty remains controversial despite existing guidelines. The aim of this study was to evaluate the transfusion practice in patients undergoing primary total hip arthroplasty (THA) or revision total hip arthroplasty (RTHA) in Denmark.
We performed a retrospective cohort study of all patients undergoing THA or RTHA in Denmark in 2008. Primary outcomes were intercentre variation in red blood cell (RBC) transfusion rates and the timing of transfusion related to surgery.
Six thousand nine hundred thirty-two THA patients and 1132 RTHA patients were included for analysis of which 1674 (24%) THA and 689 (61%) RTHA patients received RBC transfusion. Of these, 47% of THA and 73% of RTHA patients received transfusion on the day of surgery. Transfusion rates between centres varied from 7 to 71% and between 26 and 85% in THA and RTHA patients, respectively. Patients receiving RBC transfusion had longer length of stay and for THA patients an increased odds-ratio (5·5) of death within 90 days.
Despite established guidelines, RBC transfusion practice in hip arthroplasty remains highly variable between Danish hospitals. The effect of RBC transfusion on outcome after hip arthroplasty should be established in prospective randomized controlled trials.
尽管有现有指南，但髋关节置换术中的最佳输血策略仍存在争议。本研究旨在评估丹麦行初次全髋关节置换术（THA）或翻修全髋关节置换术（RTHA）患者的输血实践。
我们对 2008 年在丹麦行 THA 或 RTHA 的所有患者进行了回顾性队列研究。主要结局为红细胞（RBC）输血率的中心间差异以及与手术相关的输血时机。
共纳入 6932 例 THA 患者和 1132 例 RTHA 患者，其中 1674 例（24%）THA 和 689 例（61%）RTHA 患者接受 RBC 输血。其中，47%的 THA 和 73%的 RTHA 患者在手术当天输血。各中心的输血率在 THA 和 RTHA 患者中分别为 7%至 71%和 26%至 85%。接受 RBC 输血的患者住院时间更长，THA 患者在 90 天内死亡的优势比（OR）增加（5.5）。
尽管有既定指南，但丹麦各医院在髋关节置换术中的 RBC 输血实践仍存在高度差异。应在前瞻性随机对照试验中确定 RBC 输血对髋关节置换术后结局的影响。
