Ewing Michael A, Huntley Samuel R, Baker Dustin K, Smith Kenneth S, Hudson Parke W, McGwin Gerald, Ponce Brent A, Johnson Michael D
University of Alabama School of Medicine, Birmingham, Alabama.
Foot Ankle Spec. 2019 Apr;12(2):115-121. doi: 10.1177/1938640018768093. Epub 2018 Apr 13.
Total ankle arthroplasty (TAA) is an increasingly used, effective treatment for end-stage ankle arthritis. Although numerous studies have associated blood transfusion with complications following hip and knee arthroplasty, its effects following TAA are largely unknown. This study uses data from a large, nationally representative database to estimate the association between blood transfusion and inpatient complications and hospital costs following TAA.
Using the Nationwide Inpatient Sample (NIS) database from 2004 to 2014, 25 412 patients who underwent TAA were identified, with 286 (1.1%) receiving a blood transfusion. Univariate analysis assessed patient and hospital factors associated with blood transfusion following TAA.
Patients requiring blood transfusion were more likely to be female, African American, Medicare recipients, and treated in nonteaching hospitals. Average length of stay for patients following transfusion was 3.0 days longer, while average inpatient cost was increased by approximately 50%. Patients who received blood transfusion were significantly more likely to suffer from congestive heart failure, peripheral vascular disease, hypothyroidism, coagulation disorder, or anemia. Acute renal failure was significantly more common among patients receiving blood transfusion ( P < .001).
Blood transfusions following TAA are infrequent and are associated with multiple medical comorbidities, increased complications, longer hospital stays, and increased overall cost.
Level III: Retrospective, comparative study.
全踝关节置换术（TAA）是一种治疗终末期踝关节炎且应用日益广泛的有效方法。尽管众多研究已将输血与髋、膝关节置换术后的并发症相关联，但其在全踝关节置换术后的影响在很大程度上仍不明确。本研究利用来自一个大型、具有全国代表性数据库的数据，来评估输血与全踝关节置换术后住院并发症及住院费用之间的关联。
利用2004年至2014年的全国住院患者样本（NIS）数据库，确定了25412例行全踝关节置换术的患者，其中286例（1.1%）接受了输血。单因素分析评估了与全踝关节置换术后输血相关的患者和医院因素。
需要输血的患者更可能为女性、非裔美国人、医疗保险受益人和在非教学医院接受治疗。输血患者的平均住院时间长3.0天，而平均住院费用增加了约50%。接受输血的患者患充血性心力衰竭、外周血管疾病、甲状腺功能减退、凝血障碍或贫血的可能性显著更高。急性肾衰竭在接受输血的患者中明显更为常见（P <.001）。
全踝关节置换术后输血情况不常见，且与多种内科合并症、并发症增加、住院时间延长及总体费用增加相关。
Ⅲ级：回顾性比较研究。
