Department of Orthopedics, The Third People's Hospital of Shenzhen, 29 Bulan Road, Shenzhen, 518112, Guangdong Province, China.
Center of Clinical Epidemiology, The Third People's Hospital of Shenzhen, 29 Bulan Road, Shenzhen, 518112, Guangdong Province, China.
J Orthop Surg Res. 2022 Mar 9;17(1):155. doi: 10.1186/s13018-022-03055-y.
Patients with HIV have a higher prevalence of thrombocytopenia than those without HIV infection, increasing their risk of substantial perioperative blood loss (PBL) during total hip arthroplasty (THA). This study aimed to evaluate PBL risk factors in HIV-infected patients undergoing THA.
Eighteen HIV+ patients (21 hip joints) and 33 HIV- patients (36 joints) undergoing THA were enrolled in this study. PBL was calculated using the Gross equation, which comprises total blood loss (TBL), dominant blood loss (DBL), and hidden blood loss (HBL). Risk factors for post-THA PBL in both patient populations was evaluated using multivariable linear regression.
At baseline, the HIV+ patients were younger, more likely to be male and to have elevated hemoglobin and albumin levels, and lower erythrocyte sedimentation rates than HIV- patients. There were no differences in the T-lymphocyte subsets or coagulation function between the two groups. Age and albumin level were identified as potential HBL risk factors after THA, and albumin level was associated with higher TBL. The unadjusted linear regression analysis showed that the HBL and TBL were significantly higher in HIV+ patients than in HIV- patients. However, after adjusting for other factors, no differences in DBL, HBL, or TBL were observed between HIV- and HIV+ patients.
PBL was similar in both groups undergoing THA, regardless of their HIV-infection status. THA surgery is a safe and effective procedure in HIV+ patients.
与未感染 HIV 的患者相比，HIV 感染者血小板减少症的发生率更高，这增加了他们在全髋关节置换术（THA）中发生大量围手术期失血（PBL）的风险。本研究旨在评估接受 THA 的 HIV 感染者发生 PBL 的危险因素。
本研究纳入了 18 例 HIV 阳性患者（21 髋）和 33 例 HIV 阴性患者（36 髋）。采用 Gross 方程计算 PBL，该方程包括总失血量（TBL）、显性失血量（DBL）和隐性失血量（HBL）。使用多变量线性回归评估了两组患者术后 PBL 的危险因素。
基线时，HIV 阳性患者年龄更小，男性更多，血红蛋白和白蛋白水平更高，红细胞沉降率更低。两组患者的 T 淋巴细胞亚群和凝血功能无差异。年龄和白蛋白水平是术后 HBL 的潜在危险因素，而白蛋白水平与 TBL 较高有关。未校正的线性回归分析显示，HIV 阳性患者的 HBL 和 TBL 明显高于 HIV 阴性患者。然而，在调整其他因素后，HIV 阳性和 HIV 阴性患者的 DBL、HBL 和 TBL 无差异。
无论 HIV 感染状况如何，两组接受 THA 的患者的 PBL 相似。THA 手术在 HIV 阳性患者中是一种安全有效的手术。
