Garg Vipul, Byrom Iain, Agnew Neil, Starks Ian, Phillips Stephen, Malek Ibrahim A
Wrexham Maelor Hospital, Croesnewydd Rd, Wrexham, LL13 7TD, UK.
J Clin Orthop Trauma. 2021 Jan 17;16:114-118. doi: 10.1016/j.jcot.2021.01.003. eCollection 2021 May.
The increasing demand for Total Hip replacement (THR)/Total Hip Arthroplasty (THA) continues to place significant financial pressure on the National Health Service (NHS). Many institutions undertake post-operative blood tests routinely in this group of patients. The aim of this study was to identify if such routine blood tests (Full Blood Count (FBC) and Urea and Electrolytes(U&Es)) are required in all THR patients post-operatively.
Single institute, Multi-surgeon, retrospective observational study of consecutive patients who underwent primary elective THR done from Jan 2014 to Dec 2018.Post-operative blood tests and medical records were reviewed to identify derangement in haemoglobin (Hb) level and renal function requiring clinical intervention.
Over the period of 4 years, 353 patients underwent elective THR with mean age of 70 years (range: 42-90). There were 203 Males and 150 Females. Mean pre-operative Hb was 134.7 g/l. Mean post-operative drop in Hb was 22.3 g/l. None of the patients in ASA grade 1 and 2 with age ≤70 years required blood transfusion post operatively.6.4% of patients (n = 18/280) with an ASA of 1-2 had postoperative blood results requiring intervention of which only four (1.2%) were ≤70 years of age compared to 17.8% of patients (n = 14/73) with ASA 3-4.Overall none of the patients in ASA grade 1 and 2 with age ≤70 years required blood transfusion post operatively nor had electrolyte disturbance. 1.2% had deranged renal function that needed minor clinical intervention.
Routine post-operative blood analyses may not required for all patients undergoing THA. Young and healthier patients seldom have significant abnormalities on routine post-operative blood analyses which requires clinical intervention.
全髋关节置换术（THR）/全髋关节成形术（THA）需求的不断增加，继续给国民医疗服务体系（NHS）带来巨大的经济压力。许多机构对这类患者常规进行术后血液检查。本研究的目的是确定所有THR患者术后是否都需要进行此类常规血液检查（全血细胞计数（FBC）和尿素及电解质（U&Es））。
对2014年1月至2018年12月期间接受初次择期THR的连续患者进行单机构、多外科医生的回顾性观察研究。回顾术后血液检查和医疗记录，以确定血红蛋白（Hb）水平和肾功能紊乱是否需要临床干预。
在4年期间，353例患者接受了择期THR，平均年龄70岁（范围：42 - 90岁）。其中男性203例，女性150例。术前平均Hb为134.7g/l。术后Hb平均下降22.3g/l。年龄≤70岁的ASA 1级和2级患者术后均无需输血。ASA为1 - 2级的患者中有6.4%（n = 18/280）术后血液检查结果需要干预，其中只有4例（1.2%）年龄≤70岁，而ASA 3 - 4级的患者中有17.8%（n = 14/73）。总体而言，年龄≤70岁的ASA 1级和2级患者术后均无需输血，也无电解质紊乱。1.2%的患者肾功能紊乱需要轻微临床干预。
并非所有接受THA的患者都需要进行常规术后血液分析。年轻且健康的患者在常规术后血液分析中很少出现需要临床干预的显著异常。
