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预存式自体输血对初次全膝关节置换术围手术期血红蛋白浓度及中期健康结局的影响

Effects of Pre-Donated Autologous Blood Transfusion on Peri-Operative Hemoglobin Concentration and Mid-Term Health Outcomes in Primary Total Knee Arthroplasty.

作者信息

Tomura Jun, Morikawa Daichi, Nozawa Masahiko, Ishijima Muneaki, Kim Sung-Gon

机构信息

Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

Department of Orthopaedics, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

出版信息

J Clin Med. 2022 Apr 18;11(8):2252. doi: 10.3390/jcm11082252.

Abstract

The effects of auto-BT in primary TKA on the perioperative hemoglobin (Hb) concentration and mid-term health outcomes are unknown. This study was performed to analyze the detailed changes in the perioperative Hb concentration before and after the operation (days 0-14 postoperatively), cardiovascular events, and mortality rate within 1 and 5 years postoperatively. One hundred patients undergoing primary TKA with auto-BT using 800 mL of preoperatively collected blood at the authors' institution were included. The mean Hb concentration before and after autologous blood collection was 12.7 ± 1.1 and 11.7 ± 1.2 g/dL, respectively. After primary TKA with auto-BT, the mean Hb concentration on day 0, 1, 3, 7, and 14 was 10.2 ± 1.2, 9.9 ± 1.2, 10.4 ± 1.3, 10.5 ± 1.3, and 11.0 ± 1.3 g/dL, respectively. Only one (1%) patient required additional allogenic blood transfusion. No patients developed cardiovascular events, and the 1- and 5-year postoperative mortality rate was 1.0% and 2.0%, respectively. Primary TKA with auto-BT showed relatively small perioperative changes in the Hb concentration, a low incidence of cardiovascular events, and a low mortality rate within 1 and 5 years postoperatively. These findings suggest that auto-BT, in which blood is preoperatively collected, is beneficial for patient safety and health, even if its cost-effectiveness may be debatable.

摘要

自体血回输(auto - BT)在初次全膝关节置换术(primary TKA)中对围手术期血红蛋白(Hb)浓度及中期健康结局的影响尚不清楚。本研究旨在分析手术前后(术后0 - 14天)围手术期Hb浓度的详细变化、心血管事件以及术后1年和5年内的死亡率。纳入了100例在作者所在机构接受使用术前采集的800 mL血液进行自体血回输的初次全膝关节置换术患者。自体血采集前后的平均Hb浓度分别为12.7±1.1和11.7±1.2 g/dL。在进行自体血回输的初次全膝关节置换术后,第0、1、3、7和14天的平均Hb浓度分别为10.2±1.2、9.9±1.2、10.4±1.3、10.5±1.3和11.0±1.3 g/dL。仅1例(1%)患者需要额外输注异体血。无患者发生心血管事件,术后1年和5年的死亡率分别为1.0%和2.0%。自体血回输的初次全膝关节置换术在围手术期Hb浓度变化相对较小,心血管事件发生率低,术后1年和5年内死亡率低。这些结果表明术前采血的自体血回输即使其成本效益可能存在争议,但对患者安全和健康有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21e7/9028421/632156d2ff38/jcm-11-02252-g001.jpg

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