From the College of Nursing and.
Internal Medicine, College of Medicine, and.
J Clin Rheumatol. 2018 Dec;24(8):422-426. doi: 10.1097/RHU.0000000000000755.
BACKGROUND/OBJECTIVE: Despite effective therapies, rheumatoid arthritis (RA) can result in joint destruction requiring total joint arthroplasty to maintain patient function. An estimated 16% to 70% of those undergoing total joint arthroplasty of the hip or knee will receive a blood transfusion. Few studies have described risk factors for blood transfusion following total joint arthroplasty in patients with RA. The aim of this study was to identify demographic and clinical risk factors associated with receiving a blood transfusion following total joint arthroplasty among patients with RA.
A retrospective study (n = 3270) was conducted using deidentified patient health claims information from a commercially insured, US data set (2007-2009). Data analysis included descriptive statistics and multivariate logistic regression.
Females were more likely to receive a blood transfusion (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.16-1.87; p = 0.001). When compared with those in the South, patients residing the Midwest were less likely to receive a blood transfusion following total joint arthroplasty (OR, 0.56; 95% CI, 0.44-0.71). Relative to those receiving total knee arthroplasty, patients who underwent total hip arthroplasty were more likely to receive a blood transfusion (OR, 1.39; 95% CI, 1.14-1.70), and patients who underwent a total shoulder arthroplasty were less likely to receive a blood transfusion (OR, 0.14; 95% CI, 0.05-0.38; p < 0.001). Patients with a history of anemia were more likely to receive a blood transfusion compared with those who did not have this diagnosis (OR, 3.30; 95% CI, 2.62-4.14; p < 0.001).
Risk factors for the receipt of blood transfusions among RA patients who have undergone total joint arthroplasty were identified.
背景/目的：尽管有有效的治疗方法，但类风湿关节炎（RA）仍可能导致关节破坏，需要进行全关节置换术来维持患者的功能。接受髋关节或膝关节全关节置换术的患者中，约有 16%至 70%需要输血。很少有研究描述过 RA 患者全关节置换术后输血的风险因素。本研究的目的是确定 RA 患者全关节置换术后输血的相关人口统计学和临床风险因素。
使用来自商业保险的美国数据集（2007-2009 年）的匿名患者健康索赔信息进行回顾性研究（n=3270）。数据分析包括描述性统计和多变量逻辑回归。
女性更有可能接受输血（比值比[OR]，1.48；95%置信区间[CI]，1.16-1.87；p=0.001）。与居住在南方的患者相比，居住在中西部的患者在接受全关节置换术后接受输血的可能性较低（OR，0.56；95%CI，0.44-0.71）。与接受全膝关节置换术的患者相比，接受全髋关节置换术的患者更有可能接受输血（OR，1.39；95%CI，1.14-1.70），而接受全肩关节置换术的患者接受输血的可能性较低（OR，0.14；95%CI，0.05-0.38；p<0.001）。与没有贫血诊断的患者相比，有贫血病史的患者更有可能接受输血（OR，3.30；95%CI，2.62-4.14；p<0.001）。
确定了接受全关节置换术的 RA 患者接受输血的风险因素。
