Meißner Nils, Strahl André, Rolvien Tim, Halder Andreas M, Schrednitzki Daniel
Department of Orthopaedic Surgery, Sana Hospital Sommerfeld, Kremmen, Germany.
Department of Trauma and Orthopaedic Surgery, Division of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Bone Jt Open. 2024 Jul 7;5(7):560-564. doi: 10.1302/2633-1462.57.BJO-2023-0157.R1.
Transfusion after primary total hip arthroplasty (THA) has become rare, and identification of causative factors allows preventive measures. The aim of this study was to determine patient-specific factors that increase the risk of needing a blood transfusion.
All patients who underwent elective THA were analyzed retrospectively in this single-centre study from 2020 to 2021. A total of 2,892 patients were included. Transfusion-related parameters were evaluated. A multiple logistic regression was performed to determine whether age, BMI, American Society of Anesthesiologists (ASA) grade, sex, or preoperative haemoglobin (Hb) could predict the need for transfusion within the examined patient population.
The overall transfusion rate was 1.2%. Compared to the group of patients without blood transfusion, the transfused group was on average older (aged 73.8 years (SD 9.7) vs 68.6 years (SD 10.1); p = 0.020) and was mostly female (p = 0.003), but showed no significant differences in terms of BMI (28.3 kg/m (SD 5.9) vs 28.7 kg/m (SD 5.2); p = 0.720) or ASA grade (2.2 (SD 0.5) vs 2.1 (SD 0.4); p = 0.378). The regression model identified a cutoff Hb level of < 7.6 mmol/l (< 12.2 g/dl), aged > 73 years, and a BMI of 35.4 kg/m² or higher as the three most reliable predictors associated with postoperative transfusion in THA.
The possibility of transfusion is predictable based on preoperatively available parameters. The proposed thresholds for preoperative Hb level, age, and BMI can help identify patients and take preventive measures if necessary.
初次全髋关节置换术（THA）后输血已变得罕见，确定致病因素有助于采取预防措施。本研究的目的是确定增加输血需求风险的患者特异性因素。
在这项单中心研究中，对2020年至2021年期间接受择期THA的所有患者进行回顾性分析。共纳入2892例患者。评估了输血相关参数。进行多因素逻辑回归分析，以确定年龄、体重指数（BMI）、美国麻醉医师协会（ASA）分级、性别或术前血红蛋白（Hb）是否能够预测所研究患者群体中的输血需求。
总体输血率为1.2%。与未输血患者组相比，输血组患者平均年龄更大（73.8岁（标准差9.7）对68.6岁（标准差10.1）；p = 0.020），且大多为女性（p = 0.003），但在BMI方面无显著差异（28.3kg/m²（标准差5.9）对28.7kg/m²（标准差5.2）；p = 0.720）或ASA分级方面也无显著差异（2.2（标准差0.5）对2.1（标准差0.4）；p = 0.378）。回归模型确定Hb水平<7.6mmol/l（<12.2g/dl）、年龄>73岁以及BMI为35.4kg/m²或更高是与THA术后输血相关的三个最可靠预测因素。
根据术前可用参数可预测输血可能性。所提出的术前Hb水平、年龄和BMI阈值有助于识别患者，并在必要时采取预防措施。
