Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes
Background. Various studies have raised concern of worse outcomes in patients receiving blood transfusions perioperatively compared to those who do not. In this study we attempted to determine the proportion of perioperative complications in the orthopedic population attributable to the use of a blo...
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Wiley
2014-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2014/623460 |
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| author | Thomas Danninger Rehana Rasul Jashvant Poeran Ottokar Stundner Madhu Mazumdar Peter M. Fleischut Lazaros Poultsides Stavros G. Memtsoudis |
| author_facet | Thomas Danninger Rehana Rasul Jashvant Poeran Ottokar Stundner Madhu Mazumdar Peter M. Fleischut Lazaros Poultsides Stavros G. Memtsoudis |
| author_sort | Thomas Danninger |
| collection | DOAJ |
| description | Background. Various studies have raised concern of worse outcomes in patients receiving blood transfusions perioperatively compared to those who do not. In this study we attempted to determine the proportion of perioperative complications in the orthopedic population attributable to the use of a blood transfusion.
Methods. Data from 400 hospitals in the United States were used to identify patients undergoing total hip or knee arthroplasty (THA and TKA) from 2006 to 2010. Patient and health care demographics, as well as comorbidities and perioperative outcomes were compared. Multivariable logistic regression models were fitted to determine associations between transfusion, age, and comorbidities and various perioperative outcomes. Population attributable fraction (PAF) was determined to measure the proportion of outcome attributable to transfusion and other risk factors. Results. Of 530,089 patients, 18.93% received a blood transfusion during their hospitalization. Patients requiring blood transfusion were significantly older and showed a higher comorbidity burden. In addition, these patients had significantly higher rates of major complications and a longer length of hospitalization. The logistic regression models showed that transfused patients were more likely to have adverse health outcomes than nontransfused patients. However, patients who were older or had preexisting diseases carried a higher risk than use of a transfusion for these outcomes. The need for a blood transfusion explained 9.51% (95% CI 9.12–9.90) of all major complications. Conclusions. Advanced age and high comorbidity may be responsible for a higher proportion of adverse outcomes in THA and TKA patients than blood transfusions. |
| format | Article |
| id | doaj-art-84252a7da4be479f977e331ff134599e |
| institution | Kabale University |
| issn | 2356-6140 1537-744X |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-84252a7da4be479f977e331ff134599e2025-02-03T05:51:30ZengWileyThe Scientific World Journal2356-61401537-744X2014-01-01201410.1155/2014/623460623460Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of OutcomesThomas Danninger0Rehana Rasul1Jashvant Poeran2Ottokar Stundner3Madhu Mazumdar4Peter M. Fleischut5Lazaros Poultsides6Stavros G. Memtsoudis7Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, USADepartment of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, 402 East 67th Street, New York, NY 10065, USADepartment of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, 402 East 67th Street, New York, NY 10065, USADepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, USADepartment of Public Health, Division of Biostatistics and Epidemiology, Weill Medical College of Cornell University, 402 East 67th Street, New York, NY 10065, USADepartment of Anesthesiology, Weill Medical College of Cornell University, 402 East 67th Street, New York, NY 10065, USADepartment of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, USADepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, USABackground. Various studies have raised concern of worse outcomes in patients receiving blood transfusions perioperatively compared to those who do not. In this study we attempted to determine the proportion of perioperative complications in the orthopedic population attributable to the use of a blood transfusion. Methods. Data from 400 hospitals in the United States were used to identify patients undergoing total hip or knee arthroplasty (THA and TKA) from 2006 to 2010. Patient and health care demographics, as well as comorbidities and perioperative outcomes were compared. Multivariable logistic regression models were fitted to determine associations between transfusion, age, and comorbidities and various perioperative outcomes. Population attributable fraction (PAF) was determined to measure the proportion of outcome attributable to transfusion and other risk factors. Results. Of 530,089 patients, 18.93% received a blood transfusion during their hospitalization. Patients requiring blood transfusion were significantly older and showed a higher comorbidity burden. In addition, these patients had significantly higher rates of major complications and a longer length of hospitalization. The logistic regression models showed that transfused patients were more likely to have adverse health outcomes than nontransfused patients. However, patients who were older or had preexisting diseases carried a higher risk than use of a transfusion for these outcomes. The need for a blood transfusion explained 9.51% (95% CI 9.12–9.90) of all major complications. Conclusions. Advanced age and high comorbidity may be responsible for a higher proportion of adverse outcomes in THA and TKA patients than blood transfusions.http://dx.doi.org/10.1155/2014/623460 |
| spellingShingle | Thomas Danninger Rehana Rasul Jashvant Poeran Ottokar Stundner Madhu Mazumdar Peter M. Fleischut Lazaros Poultsides Stavros G. Memtsoudis Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes The Scientific World Journal |
| title | Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes |
| title_full | Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes |
| title_fullStr | Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes |
| title_full_unstemmed | Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes |
| title_short | Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes |
| title_sort | blood transfusions in total hip and knee arthroplasty an analysis of outcomes |
| url | http://dx.doi.org/10.1155/2014/623460 |
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