Preoperative hemogram as a predictive factor for iron deficit and/or transfusion in patients scheduled for arthroplasty.

Autor: Zalba Marcos S; Servicio de Hematología y Hemoterapia, Complejo Hospitalario de Navarra., Galbete A; Navarrabiomed-Complejo Hospitalario de Navarra-UPNA, IDISNA, REDISSEC, Pamplona, España., Urrechaga Igartua E; Biocruces Bizkaia Research Institute, Bilbao, España., Antelo Caamaño ML; Servicio de Apoyo a la Gestión Clínica y Calidad Asistencial, Complejo Hospitalario de Navarra, Pamplona, Navarra, España., Cerdán G; Servicio de Anestesiología y Reanimación, Hospital García Orcoyen, Estella, Navarra, España., García Erce JA; Banco de Sangre y Tejidos de Navarra, Servicio Navarro de Salud, Osasunbidea, Pamplona, España; Grupo Español de Rehabilitación Multimodal (GERM), Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; PBM Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, España. Electronic address: jagarciaerce@gmail.com.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de anestesiologia y reanimacion [Rev Esp Anestesiol Reanim (Engl Ed)] 2021 Jul 21. Date of Electronic Publication: 2021 Jul 21.
DOI: 10.1016/j.redar.2021.02.004
Abstrakt: Introduction: Anemia and iron deficiency predispose to an increased risk of transfusion with a consequent increase in morbidity and mortality. The study analyzes whether blood cell count parameters in addition to detecting anemia can predict iron deficiency and/or transfusional risk in patients undergoing mostly to scheduled primary hip and knee arthroplasty.
Objective: To analyze how blood cell count parameters predict iron deficiency and/or transfusional risk in patients undergoing programmed arthroplasty.
Material and Methods: The analytical and transfusion results of 522 patients undergoing arthroplasty have been prospectively collected between 2013 and 2019 and the discriminative and predictive capacity of the basic parameters of the red cells have been analyzed; hemoglobin (Hb), mean cell volume, mean cell hemoglobin (HCM) and red blood cell distribution width (RDW) for the identification of presurgical iron deficiency and postsurgical transfusion.
Results: Anaemia was detected in 6.6%, "suboptim" Hb (<13g/dL) in 14.5% and iron deficiency in 32.4%. Anemia detects only 13.8% of ID. After logistic regression analysis, the multivariate model significantly related Hb (p=.004), mean corpuscular hemoglobin (MCH) (p=.026), and the red cell distribution width (RDW) (p=.001) with ID; but mean corpuscular volume (MCV) is not significant. Hb, age and transferrin saturation index have been the only risk factors for transfusional risk of the parameters analyzed.
Conclusions: The hemogram contains parameters that correlate with iron deficiency, however, mean cell volume, so widely used for the orientation of iron deficiency, is not valid as a discriminator of iron deficiency in this group of patients. Low Hb and transferrin saturation index are modifiable predictors for transfusion risk.
(Copyright © 2021 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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