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术前贫血与髋关节和膝关节翻修置换术中异体浓缩红细胞输注量增加相关:一项对某高容量单一中心10年间5387例患者的回顾性分析。

Preoperative anaemia is associated with increased allogeneic pack red cell transfusion in revision hip and knee joint arthroplasty: a retrospective analysis of 5387 patients over a 10-year period at a single high volume centre.

作者信息

Kasivisvanathan R, Ramesh V, Rao Baikady R, Nadaraja S

机构信息

The Royal Marsden NHS Foundation Trust, London, UK.

The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.

出版信息

Transfus Med. 2016 Aug;26(4):271-7. doi: 10.1111/tme.12322. Epub 2016 May 31.

Abstract

OBJECTIVES

To estimate the prevalence of preoperative World Health Organization (WHO) defined anaemia in patients presenting for revision hip and knee arthroplasty and its association with transfusion of allogeneic packed red blood cells (PRBC).

BACKGROUND

Studies have mainly investigated the prevalence of preoperative anaemia in primary and not revision hip and knee joint arthroplasty.

METHODS

An analysis of a prospectively collected patient data for 5387 patients having revision hip or knee arthroplasty over a 10-year period at a single high volume centre was conducted. Logistic regression was used to assess whether the presence of WHO defined preoperative anaemia as well as other risk factors were associated with inpatient allogeneic PRBC transfusion.

RESULTS

There were 5387 patients assessed of which 3021 (56·01%) patients had revision total hip replacements and 2366 (43·09%) had revision total knee arthroplasty. Of these patients 1956 (36·03%) had preoperative WHO defined anaemia. A total of 2034 (37·08%) patients received at least one unit of allogeneic PRBC during their primary hospital admission. In the final model preoperative WHO defined anaemia was independently associated with allogeneic PRBC transfusion in hip and knee revision surgery OR 4·042 (4·012-4·072 95% CI) CONCLUSIONS: Preoperative anaemia is common in patients presenting for revision hip and knee arthroplasty and independently associated with transfusion of allogeneic PRBC.

摘要

目的

评估因髋关节和膝关节翻修置换术就诊患者术前世界卫生组织(WHO)定义的贫血患病率及其与异体浓缩红细胞(PRBC)输血的相关性。

背景

既往研究主要调查初次髋关节和膝关节置换术而非翻修置换术患者术前贫血的患病率。

方法

对一个高容量中心10年间5387例行髋关节或膝关节翻修置换术患者的前瞻性收集的患者数据进行分析。采用逻辑回归评估WHO定义的术前贫血的存在以及其他危险因素是否与住院期间异体PRBC输血相关。

结果

共评估了5387例患者,其中3021例(56.01%)接受了髋关节翻修置换术,2366例(43.09%)接受了膝关节翻修置换术。在这些患者中,1956例(36.03%)术前存在WHO定义的贫血。共有2034例(37.08%)患者在初次住院期间接受了至少1单位的异体PRBC。在最终模型中,术前WHO定义的贫血与髋关节和膝关节翻修手术中异体PRBC输血独立相关,比值比为4.042(4.012 - 4.072,95%置信区间)。结论:术前贫血在因髋关节和膝关节翻修置换术就诊的患者中很常见,且与异体PRBC输血独立相关。

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