Predicting Perioperative Transfusion in Elective Hip and Knee Arthroplasty
| Autor: | Susan Kim, Romi Sinha, Donald W. Howie, Josephine To, Luen Bik To, Brendon Kearney, Kathryn Robinson |
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| Rok vydání: | 2017 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty business.industry medicine.medical_treatment Perioperative Odds ratio 030204 cardiovascular system & hematology Logistic regression Preoperative care Arthroplasty Surgery 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine Medicine Derivation Elective surgery business Elective Surgical Procedure |
| Zdroj: | Anesthesiology. 127:317-325 |
| ISSN: | 0003-3022 |
| Popis: | Background Preoperative anemia is a significant predictor of perioperative erythrocyte transfusion in elective arthroplasty patients. However, interactions with other patient and procedure characteristics predicting transfusion requirements have not been well studied. Methods Patients undergoing elective primary total hip arthroplasty or total knee arthroplasty at a tertiary hospital in Adelaide, South Australia, Australia, from January 2010 to June 2014 were used to identify preoperative predictors of perioperative transfusion. A logistic regression model was developed and externally validated with an independent data set from three other hospitals in Adelaide. Results Altogether, 737 adult patients in the derivation group and 653 patients in the validation group were included. Binary logistic regression modeling identified preoperative hemoglobin (odds ratio, 0.51; 95% CI, 0.43 to 0.59; P < 0.001 for each 1 g/dl increase), total hip arthroplasty (odds ratio, 3.56; 95% CI, 2.39 to 5.30; P < 0.001), and females 65 yr of age and older (odds ratio, 3.37; 95% CI, 1.88 to 6.04; P = 0.01) as predictors of transfusion in the derivation cohort. Conclusions Using a combination of patient-specific preoperative variables, this validated model can predict transfusion in patients undergoing elective hip and knee arthroplasty. The model may also help to identify patients whose need for transfusion may be decreased through preoperative hemoglobin optimization. |
| Databáze: | OpenAIRE |
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