Chutarattanakul Phasuth, Kaewpornsawan Kamolporn, Wongcharoenwatana Jidapa, Musikachart Piyanuch, Eamsobhana Perajit
Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Children (Basel). 2022 Jan 27;9(2):161. doi: 10.3390/children9020161.
This study investigated the association between postoperative blood transfusion and the incidence of postoperative complications 30 days after pediatric hip surgery as well as factors significantly associated with 30-day postoperative complications. Patients were divided into two groups: those with postoperative complications and those with no complications. Postoperative hematocrit (Hct) was categorized as <25%, 25-30%, and >30%. Comparison was made between all postoperative complications at the 30-day follow-up that were influenced by anemia in patients who received transfusion and those who did not. A multivariate logistic regression model was used to identify factors independently associated with postoperative complications. The overall 30-day postoperative complication rate for all patients was 17% (24/138). No significant difference between the transfusion and the non-transfusion patients was found. Preoperative hematocrit (Hct) was significantly lower in the complications group ( = 0.030), and both length of stay and 30-day readmission were significantly higher in patients with complications ( = 0.011 and < 0.001, respectively). Multivariate analysis revealed female gender (OR: 3.50, 95% CI: 1.18-10.36; = 0.026) and length of hospital stay (OR: 1.23, 95% CI: 1.08-1.41; = 0.004) to be factors independently associated with 30-day postoperative complications. However, no statistically significant difference in the incidence of complications at 30 days following pediatric hip dysplasia surgery was found between patients who received blood transfusion to maintain a Hct level ≥25% and those not receiving transfusion.
本研究调查了小儿髋关节手术后输血与术后30天并发症发生率之间的关联,以及与术后30天并发症显著相关的因素。患者分为两组:有术后并发症的患者和无并发症的患者。术后血细胞比容(Hct)分为<25%、25 - 30%和>30%。对输血和未输血患者中受贫血影响的所有术后30天随访并发症进行了比较。使用多因素逻辑回归模型来确定与术后并发症独立相关的因素。所有患者术后30天的总体并发症发生率为17%(24/138)。输血患者和未输血患者之间未发现显著差异。并发症组术前血细胞比容(Hct)显著更低(P = 0.030),并发症患者的住院时间和30天再入院率均显著更高(分别为P = 0.011和P < 0.001)。多因素分析显示女性性别(OR:3.50,95%CI:1.18 - 10.36;P = 0.026)和住院时间(OR:1.23,95%CI:1.08 - 1.41;P = 0.004)是与术后30天并发症独立相关的因素。然而,在接受输血以维持Hct水平≥25%的患者和未接受输血的患者之间,小儿髋关节发育不良手术后30天的并发症发生率未发现统计学上的显著差异。