Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database study
Abstract Objectives Allogeneic blood transfusion is a common therapeutic intervention for patients with rheumatoid arthritis (RA) undergoing lower extremity joint replacement (LEJR). Despite the potential for adverse outcomes associated with blood transfusion, the risks related to this procedure in...
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BMC
2025-08-01
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| Series: | BMC Rheumatology |
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| Online Access: | https://doi.org/10.1186/s41927-025-00554-3 |
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| author | Wenyan Geng Lulu Ye Xuegao Yu Qinfeng Yang Linlin Wang Xiaodan Li Qing Xiao Jian Wang |
| author_facet | Wenyan Geng Lulu Ye Xuegao Yu Qinfeng Yang Linlin Wang Xiaodan Li Qing Xiao Jian Wang |
| author_sort | Wenyan Geng |
| collection | DOAJ |
| description | Abstract Objectives Allogeneic blood transfusion is a common therapeutic intervention for patients with rheumatoid arthritis (RA) undergoing lower extremity joint replacement (LEJR). Despite the potential for adverse outcomes associated with blood transfusion, the risks related to this procedure in RA patients remain underexplored, particularly within the framework of a large-scale national dataset. Methods This study analyzed data from the National Inpatient Sample (NIS) database from 2010 to 2019, identifying 66,674 patients diagnosed with RA who underwent LEJR. These cases were subsequently divided into two groups based on whether they received blood transfusion. Univariate and multivariate logistic regression analyses were conducted on patient demographics, the prevalence of comorbidities, hospital-level characteristics, total financial charges, insurance coverage, and in-hospital mortality rates. Results The cumulative blood transfusion rate among RA patients undergoing LEJR was 10.9%, showing a declining trend over the study period (from 23.79% in 2010 to 3.67% in 2019). Several factors were associated with an increased likelihood of receiving blood transfusion, including advanced age (≥ 65 years), female sex, deficiency anemia, chronic blood loss anemia, weight loss, coagulopathy, fluid and electrolyte imbalances, neurological disorders, pulmonary circulatory disturbances, congestive heart failure, chronic kidney disease, and uncomplicated diabetes. Moreover, patients who received blood transfusion demonstrated a higher risk of specific complications, including wound infection, acute myocardial infarction, pneumonia, acute kidney injury, urinary tract infection, postoperative delirium, deep vein thrombosis, lower limb nerve injury, sepsis, and respiratory failure. Conclusion Thorough preoperative assessment is essential for identifying RA patients who were more likely to receive blood transfusion and be subjected to adverse outcomes. Proactive interventions during the perioperative period, coupled with the implementation of a comprehensive blood management strategy, can optimize blood transfusion in RA patients after LEJR. |
| format | Article |
| id | doaj-art-df0241143a3f4e4e8133407dc662450f |
| institution | Kabale University |
| issn | 2520-1026 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Rheumatology |
| spelling | doaj-art-df0241143a3f4e4e8133407dc662450f2025-08-20T03:46:16ZengBMCBMC Rheumatology2520-10262025-08-019111310.1186/s41927-025-00554-3Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database studyWenyan Geng0Lulu Ye1Xuegao Yu2Qinfeng Yang3Linlin Wang4Xiaodan Li5Qing Xiao6Jian Wang7Department of Blood Transfusion, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical UniversityGuangxi University of Chinese MedicineDepartment of Laboratory Medicine, The First Affiliated Hospital, Sun Yat- sen UniversityDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDepartment of Blood Transfusion, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical UniversityDepartment of Blood Transfusion, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical UniversityDepartment of Blood Transfusion, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical UniversityDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityAbstract Objectives Allogeneic blood transfusion is a common therapeutic intervention for patients with rheumatoid arthritis (RA) undergoing lower extremity joint replacement (LEJR). Despite the potential for adverse outcomes associated with blood transfusion, the risks related to this procedure in RA patients remain underexplored, particularly within the framework of a large-scale national dataset. Methods This study analyzed data from the National Inpatient Sample (NIS) database from 2010 to 2019, identifying 66,674 patients diagnosed with RA who underwent LEJR. These cases were subsequently divided into two groups based on whether they received blood transfusion. Univariate and multivariate logistic regression analyses were conducted on patient demographics, the prevalence of comorbidities, hospital-level characteristics, total financial charges, insurance coverage, and in-hospital mortality rates. Results The cumulative blood transfusion rate among RA patients undergoing LEJR was 10.9%, showing a declining trend over the study period (from 23.79% in 2010 to 3.67% in 2019). Several factors were associated with an increased likelihood of receiving blood transfusion, including advanced age (≥ 65 years), female sex, deficiency anemia, chronic blood loss anemia, weight loss, coagulopathy, fluid and electrolyte imbalances, neurological disorders, pulmonary circulatory disturbances, congestive heart failure, chronic kidney disease, and uncomplicated diabetes. Moreover, patients who received blood transfusion demonstrated a higher risk of specific complications, including wound infection, acute myocardial infarction, pneumonia, acute kidney injury, urinary tract infection, postoperative delirium, deep vein thrombosis, lower limb nerve injury, sepsis, and respiratory failure. Conclusion Thorough preoperative assessment is essential for identifying RA patients who were more likely to receive blood transfusion and be subjected to adverse outcomes. Proactive interventions during the perioperative period, coupled with the implementation of a comprehensive blood management strategy, can optimize blood transfusion in RA patients after LEJR.https://doi.org/10.1186/s41927-025-00554-3Rheumatoid arthritisLower extremity joint replacementTransfusionRisk factors |
| spellingShingle | Wenyan Geng Lulu Ye Xuegao Yu Qinfeng Yang Linlin Wang Xiaodan Li Qing Xiao Jian Wang Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database study BMC Rheumatology Rheumatoid arthritis Lower extremity joint replacement Transfusion Risk factors |
| title | Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database study |
| title_full | Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database study |
| title_fullStr | Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database study |
| title_full_unstemmed | Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database study |
| title_short | Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database study |
| title_sort | patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis a nationwide inpatient sample database study |
| topic | Rheumatoid arthritis Lower extremity joint replacement Transfusion Risk factors |
| url | https://doi.org/10.1186/s41927-025-00554-3 |
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