Tomura Jun, Morikawa Daichi, Nozawa Masahiko, Ishijima Muneaki, Kim Sung-Gon
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.
J Clin Med. 2022 Apr 18;11(8):2252. doi: 10.3390/jcm11082252.
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.
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。