The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.
Clin Orthop Relat Res. 2012 Oct;470(10):2695-701. doi: 10.1007/s11999-012-2435-z.
Anemia is common in patients undergoing total joint arthroplasty (TJA). Numerous studies have associated anemia with increased risk of infection, length of hospital stay, and mortality in surgical populations. However, it is unclear whether and to what degree preoperative anemia in patients undergoing TJA influences postoperative periprosthetic joint infection (PJI) and mortality.
QUESTIONS/PURPOSES: We therefore (1) determined the incidence of preoperative anemia in patients undergoing TJA; (2) assessed the possible association between preoperative anemia and subsequent PJI; and (3) explored the relationship between preoperative anemia with postoperative mortality.
We identified 15,722 patients who underwent TJA from January 2000 to June 2007. Anemia was defined as hemoglobin < 12 g/dL in women and hemoglobin < 13 g/dL in men. We determined the effect of preoperative anemia, demographics, and comorbidities on postoperative complications.
Of the 15,222 patients, 19.6% presented with preoperative anemia. PJI occurred more frequently in anemic patients at an incidence of 4.3% in anemic patients compared with 2% in nonanemic patients. Thirty-day (0.4%), 90-day (0.6%), and 1-year (1.8%) mortality rates were not higher in patients with preoperative anemia. Forty-four percent of anemic patients received an allogenic transfusion compared with only 13.4% of nonanemic patients. Anemic patients had increased hospital stays averaging 4.3 days compared with 3.9 days in nonanemic patients. Anemia did not predict cardiac complications.
Our data demonstrate that preoperative anemia is associated with development of subsequent PJI. Preoperative anemia was not associated with 30-day, 60-day, or 1-year mortality in this cohort.
Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
贫血在接受全关节置换术（TJA）的患者中很常见。许多研究表明，贫血与手术人群的感染风险增加、住院时间延长和死亡率升高有关。然而，目前尚不清楚 TJA 患者术前贫血是否以及在何种程度上影响术后假体周围关节感染（PJI）和死亡率。
问题/目的：因此，我们（1）确定接受 TJA 的患者术前贫血的发生率；（2）评估术前贫血与随后发生 PJI 之间的可能关联；（3）探讨术前贫血与术后死亡率之间的关系。
我们从 2000 年 1 月至 2007 年 6 月确定了 15,722 例接受 TJA 的患者。贫血定义为女性血红蛋白<12g/dL，男性血红蛋白<13g/dL。我们确定了术前贫血、人口统计学和合并症对术后并发症的影响。
在 15,222 例患者中，19.6%存在术前贫血。贫血患者发生 PJI 的频率更高，贫血患者的发生率为 4.3%，而非贫血患者的发生率为 2%。30 天（0.4%）、90 天（0.6%）和 1 年（1.8%）的死亡率在术前贫血患者中并不更高。44%的贫血患者接受了异体输血，而非贫血患者仅为 13.4%。贫血患者的平均住院时间为 4.3 天，而非贫血患者为 3.9 天。贫血与心脏并发症无关。
我们的数据表明，术前贫血与随后发生 PJI 有关。在本队列中，术前贫血与 30 天、60 天或 1 年死亡率无关。
III 级，诊断研究。有关证据水平的完整描述，请参见作者指南。
