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|Title:||Blood management in total hip replacement: an analysis of factors associated with allogenic blood transfusion|
|Epworth Authors:||Tang, Howard|
de Steiger, Richard
|Other Authors:||Wong, Samuel|
|Keywords:||Allogenic Blood Transfusion|
Total Hip Replacement
Epworth HealthCare Hospitals
Blood Saving Techniques
Autologous Blood Transfusion
Acute Normovolaemic Haemodilution
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
|Citation:||ANZ J Surg. 2015 Jun;85(6):461-5|
|Abstract:||The aim of this study was to audit the blood transfusion practice throughout the Epworth Healthcare Hospitals for patients undergoing primary total hip replacement (THR). We determined if blood-saving techniques were having an impact on the risk of allogenic blood transfusion and which patients were at risk of receiving allogenic blood transfusion. This study uses a retrospective audit of 787 patients who had undergone primary THR surgery at three Melbourne hospitals: Epworth Richmond, Epworth Eastern and Epworth Freemasons in 2010. Patient demographics, transfusion requirements and blood-conserving techniques were recorded. One hundred and eighty (23%) patients received allogenic blood transfusion and 18 (2.3%) patients received . On multivariate analysis, preoperative anaemia (odds ratio (OR) 4.7, P < 0.0001), female gender (OR 3.1, P < 0.0001) and patient age (OR 1.07 per year of age increase, P < 0.0001) were shown to be significantly associated with higher risk of allogenic blood transfusion. Use of spinal anaesthetic was found to be associated with lower risk of transfusion (OR 0.6, P = 0.0180) compared with general anaesthetic alone. Cell saver, acute normovolaemic haemodilution and re-infusion drain tube usage did not have a significant impact on reducing the risk of allogenic blood transfusion. Identification of patients at risk of blood transfusion, correction of preoperative anaemia and a restrictive transfusion policy are important factors to consider in effective perioperative blood management.|
|Journal Title:||ANZ Journal of Surgery|
|Affiliated Organisations:||Western Hospital, Melbourne, Victoria, Australia.|
Northern Hospital, Melbourne, Victoria, Australia.
|Type of Clinical Study or Trial:||Cohort Study|
|Appears in Collections:||Musculoskeletal|
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