Document Detail


Changing transfusion practice in total hip arthroplasty: observational study of the reduction of blood use over 6 years.
MedLine Citation:
PMID:  23127447     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Patients undergoing primary total hip arthroplasty (THA) have historically been over-transfused. In a district general hospital setting, the authors observed a significant downward trend in blood transfusion requirements in these patients over 6 years after a change in transfusion policy. The purpose of this study was to retrospectively analyze the change in transfusion practice and present the results of the restrictive transfusion policy.All patients undergoing primary THA between January 2003 and December 2008 were identified from hospital records. Pre- and postoperative hemoglobin levels, transfusion trigger hemoglobin, blood transfusion requirements, patient age and sex, 30-day mortality, and length of stay data were analyzed for all patients. A total of 1169 primary THAs were performed. Annual allogeneic blood transfusion requirements reduced progressively from 151 units in 2003 to 90 units in 2008 despite an increase in the number of patients undergoing THA. During this period, the proportion of patients transfused decreased from 35% to 17%. A reduction of mean transfusion trigger hemoglobin from 79 to 73 g/L was observed over the study period. No patient experienced any significant complications as a result of undertransfusion.The authors' institution has steadily restricted the use of blood transfusion in patients undergoing THA to those symptomatic of anemia. Increasing confidence among medical and nursing staff that reduced postoperative hemoglobin levels can be safely tolerated has resulted in a 55% reduction in blood transfusion in patients undergoing THA with no other change of practice.
Authors:
Paul M Robinson; Nnamdi Obi; Timothy Harrison; James Jeffery
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Orthopedics     Volume:  35     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1586-91     Citation Subset:  IM    
Copyright Information:
Copyright 2012, SLACK Incorporated.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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