Estimated blood loss and anemia predict transfusion after total shoulder arthroplasty: a retrospective cohort study
| Autor: | Lynn M. Robbins, Diane J. Morton, Melissa L. Wilson, Amber L. Childress, Katherine A. Burns, Angela R. LeMarr |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Blood transfusion Anemia periprosthetic fracture medicine.medical_treatment estimated blood loss Prosthesis Article 03 medical and health sciences proximal humerus fracture 0302 clinical medicine medicine 030222 orthopedics business.industry Transfusion Area under the curve Retrospective cohort study 030229 sport sciences hemoglobin medicine.disease anemia Arthroplasty Surgery Cohort shoulder arthroplasty Hemoglobin business |
| Zdroj: | JSES Open Access |
| ISSN: | 2468-6026 |
| DOI: | 10.1016/j.jses.2019.08.003 |
| Popis: | Background Reported blood transfusion rates after total shoulder arthroplasty (TSA) range from 4.5% to 43%, and reported risk factors include race, female sex, prosthesis type (reverse), revision, age, anemia, low preoperative hemoglobin, and number of comorbidities. The purpose of this study was to develop a predictive model for transfusion in anatomic/hemi and reverse shoulder arthroplasty patients and to estimate the transfusion rate in a community hospital setting. Methods A retrospective cohort of 265 shoulder arthroplasties (79 anatomic, 182 reverse, and 4 hemiarthroplasties) performed consecutively by 1 surgeon at 1 institution from May 2013 to May 2016 was assembled. Two patients were excluded for insufficient data, leaving 263 patients for analysis. Sensitivity, specificity, area under the curve, and cut points using estimated blood loss (EBL), history of anemia, and preoperative hemoglobin level were calculated, based on a logistic regression model. Results The overall transfusion rate was 2.3% (6/265). Higher EBL (P = .003), lower preoperative hemoglobin level (P = .030), and history of anemia (P = .088) were predictive of transfusion with a sensitivity of 80.0% and a specificity of 99.6%. In this cohort, patients with a history of anemia had transfusion risk when an EBL of ≥300 mL was combined with a preoperative hemoglobin level |
| Databáze: | OpenAIRE |
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