Luangwaranyoo Aris, Suksintharanon Methasit, Tangadulrat Pasin, Iamthanaporn Khanin, Hongnaparak Theerawit, Yuenyongviwat Varah
Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Geriatr Orthop Surg Rehabil. 2020 Nov 22;11:2151459320972993. doi: 10.1177/2151459320972993. eCollection 2020.
Hemi hip arthroplasty is one treatment option for femoral neck fractures; however, there has been limited evidence on factors associated with blood transfusions following hemi hip arthroplasty. Hence, the aim of this study was to identify the predictors of blood transfusion after hemi hip arthroplasty, which could lead to the establishment of proper guidelines for management protocols.
This study was a retrospective cohort study, conducted in a single center of 323 femoral neck fracture patients having undergone hemi hip arthroplasty. Peri-operative factors and demographic data were extracted from the electronic medical records, from 2007 to 2019. A predictive model was developed by logistic regression (LR), and adjusted by multivariate logistic regression.
One hundred and twenty-six (39%) patients received blood transfusions. On multivariate analysis, those of a female gender (odds ratio (OR) 2.00, p = 0.037), having a body mass index lower than 18.5 kg/m (OR 2.40, p = 0.028), lower preoperative hemoglobin levels (OR 0.52, p < 0.001) and given general anesthesia (OR 2.07, p = 0.028) were shown to be significantly associated with a higher risk of requiring a blood transfusion.
The authors recommend that preparation of blood components coupled with the utilization of blood conserving methods for high risk patients, as studies have stated, in addition to the consideration of spinal anesthesia; if patients have no contraindication, should be implemented.
半髋关节置换术是股骨颈骨折的一种治疗选择;然而,关于半髋关节置换术后输血相关因素的证据有限。因此,本研究的目的是确定半髋关节置换术后输血的预测因素,这可能有助于建立适当的管理方案指南。
本研究为回顾性队列研究,在单一中心对323例行半髋关节置换术的股骨颈骨折患者进行。从2007年至2019年的电子病历中提取围手术期因素和人口统计学数据。通过逻辑回归(LR)建立预测模型,并通过多变量逻辑回归进行调整。
126例(39%)患者接受了输血。多变量分析显示,女性(优势比(OR)2.00,p = 0.037)、体重指数低于18.5 kg/m(OR 2.40,p = 0.028)、术前血红蛋白水平较低(OR 0.52,p < 0.001)以及接受全身麻醉(OR 2.07,p = 0.028)与输血风险较高显著相关。
作者建议,正如研究所述,除考虑脊髓麻醉外,应为高危患者准备血液成分并采用血液保护方法;若患者无禁忌证,均应实施。