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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
Blood Loss
Blood Transfusion
Clinical Audit
Hip Replacement
Epworth HealthCare Hospitals
Blood Saving Techniques
Autologous Blood Transfusion
Acute Normovolaemic Haemodilution
Reinfusion Drain
Cell Saver
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jun-2015
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.
DOI: 10.1111/ans.13048
PubMed URL:
ISSN: 1445-1433
Journal Title: ANZ Journal of Surgery
Type: Journal Article
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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