TY - JOUR
T1 - Intraoperative hemorrhage in revision total hip arthroplasty
T2 - a retrospective single-center study
AU - Saito, Kana
AU - Kaiho, Yu
AU - Tamii, Toru
AU - Nakamura, Tadaho
AU - Kameyama, Eri
AU - Yamauchi, Masanori
N1 - Funding Information:
One pack of prepared autologous blood contained 400 mL. Variables with p<0.10 in the univariate logistic regression analysis were entered in the multivariate logistic regression analysis reTHA revision total hip arthroplasty, CRC concentrated red cell, OR odds ratio, CI confidence interval *p < 0.05 between the groups Acknowledgements This study was supported by JSPS KAKEN (Grant number 15K20028 and 17K16753). We acknowledge Dr. Akane Ui and Ms. Akiko Endo, a medical assistant, who helped with data collection.
Publisher Copyright:
© 2019, Japanese Society of Anesthesiologists.
PY - 2019/6/20
Y1 - 2019/6/20
N2 - Purpose: The amount of intraoperative hemorrhages and factors associated with hemorrhages and transfusions during revision total hip arthroplasty (reTHA) have not been identified for Japanese patients. We aimed to clarify the amount of intraoperative hemorrhages, and to elucidate the factors associated with hemorrhages and transfusions during reTHA in Japanese patients. Methods: We retrospectively reviewed patients who underwent reTHA (n = 48) and primary total hip arthroplasty (pTHA) (n = 615) in a single hospital and extracted data regarding hemorrhage, transfusion, patient comorbidities, and surgical anesthesia. We defined massive blood loss (MBL) as a hemorrhage comprising more than half of the circulating blood volume within 3 h. The odds ratio (OR) and 95% confidence interval (CI) were estimated using a multivariate logistic regression analysis. Results: There was a significant difference in hemorrhages between reTHA and pTHA patients (1790 g versus 625 g; p < 0.001). Among patients with reTHA, MBL was significantly associated with younger age (OR 0.91; 95% CI 0.84–1.00; p = 0.04) and lower body mass index (BMI) (OR 0.69; 95% CI 0.53–0.91; p = 0.01). Although not significant, the incidence of MBL tended to be higher for patients with hyperlipidemia (OR 4.88; 95% CI 0.99–24.1; p = 0.051). Furthermore, the need for allogeneic transfusion was significantly associated with the number of prepared autologous blood packs (OR 0.15; 95% CI 0.07–0.55; p = 0.002). Conclusion: Although this study was limited by its small population and a possibility of underestimating the hemorrhage, hemorrhages in reTHA patients was two times greater than that in pTHA patients. Younger age and lower BMI increased the risk of MBL in reTHA. Preparing autologous blood decreased the risk of intraoperative allogeneic transfusion.
AB - Purpose: The amount of intraoperative hemorrhages and factors associated with hemorrhages and transfusions during revision total hip arthroplasty (reTHA) have not been identified for Japanese patients. We aimed to clarify the amount of intraoperative hemorrhages, and to elucidate the factors associated with hemorrhages and transfusions during reTHA in Japanese patients. Methods: We retrospectively reviewed patients who underwent reTHA (n = 48) and primary total hip arthroplasty (pTHA) (n = 615) in a single hospital and extracted data regarding hemorrhage, transfusion, patient comorbidities, and surgical anesthesia. We defined massive blood loss (MBL) as a hemorrhage comprising more than half of the circulating blood volume within 3 h. The odds ratio (OR) and 95% confidence interval (CI) were estimated using a multivariate logistic regression analysis. Results: There was a significant difference in hemorrhages between reTHA and pTHA patients (1790 g versus 625 g; p < 0.001). Among patients with reTHA, MBL was significantly associated with younger age (OR 0.91; 95% CI 0.84–1.00; p = 0.04) and lower body mass index (BMI) (OR 0.69; 95% CI 0.53–0.91; p = 0.01). Although not significant, the incidence of MBL tended to be higher for patients with hyperlipidemia (OR 4.88; 95% CI 0.99–24.1; p = 0.051). Furthermore, the need for allogeneic transfusion was significantly associated with the number of prepared autologous blood packs (OR 0.15; 95% CI 0.07–0.55; p = 0.002). Conclusion: Although this study was limited by its small population and a possibility of underestimating the hemorrhage, hemorrhages in reTHA patients was two times greater than that in pTHA patients. Younger age and lower BMI increased the risk of MBL in reTHA. Preparing autologous blood decreased the risk of intraoperative allogeneic transfusion.
KW - Hemorrhage
KW - Revision total hip arthroplasty
KW - Transfusion
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U2 - 10.1007/s00540-019-02644-2
DO - 10.1007/s00540-019-02644-2
M3 - Article
C2 - 31037365
AN - SCOPUS:85065178545
VL - 33
SP - 399
EP - 407
JO - Journal of Anesthesia
JF - Journal of Anesthesia
SN - 0913-8668
IS - 3
ER -