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Multicentre cohort study of red blood cell use for revision hip arthroplasty and factors associated with greater risk of allogeneic blood transfusion

Walsh, T. S.; Palmer, J.; Watson, D.; Biggin, K.; Seretny, M.; Davidson, H.; Harkness, Mairi; Hay, A.

Authors

T. S. Walsh

J. Palmer

D. Watson

K. Biggin

M. Seretny

H. Davidson

Mairi Harkness

A. Hay



Abstract

Background Revision hip arthroplasty (RHA) is associated with high rates of allogeneic blood transfusion (ABT). We aimed to determine factors associated with ABT in patients undergoing RHA in Scottish hospitals, with particular focus on perioperative cell salvage (PCS).
Methods A prospective observational cohort study of RHA procedures performed in 11 hospitals over 7 months was performed. We recorded predefined patient, surgery-related, and blood conservation factors that may influence perioperative ABT, together with postoperative haemoglobin (Hb) data and ABTs to day 7. We explored factors with strongest independent association with ABT during the perioperative period using multiple regression analysis.
Results Two hundred and ten cases were studied, of whom 58% received ABTs (mean 1.8 units), most of which (52%) occurred on the day of surgery. Eighty-eight (42%) patients received PCS, of whom 68 had red cells re-infused [mean re-infusion volume 312 ml (1st, 3rd quartile: 260, 363 ml)]. In unadjusted comparisons, patients receiving PCS had lower intraoperative (9% vs 40%) and total (55% vs 63%) exposure to ABTs. The mean (95% confidence interval) theatre blood loss was 1013 (899–1128) ml and was higher for combined femoral/acetabular revision and femoral revision than other categories. The mean postoperative Hb transfusion trigger was 80 g litre−1. In multivariable models, preoperative Hb [odds ratio (OR) 0.35; P

Journal Article Type Article
Acceptance Date Aug 24, 2011
Publication Date 2012-01
Deposit Date Nov 13, 2015
Print ISSN 0007-0912
Electronic ISSN 1471-6771
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 108
Issue 1
Pages 63-71
DOI https://doi.org/10.1093/bja/aer326
Keywords Blood transfuion; revision hip arthroplasty;
Public URL http://researchrepository.napier.ac.uk/id/eprint/9278
Publisher URL http://dx.doi.org/10.1093/bja/aer326