Document Detail

Preoperative anemia in total joint arthroplasty: is it associated with periprosthetic joint infection?
MedLine Citation:
PMID:  22773393     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Anemia is common in patients undergoing total joint arthroplasty (TJA). Numerous studies have associated anemia with increased risk of infection, length of hospital stay, and mortality in surgical populations. However, it is unclear whether and to what degree preoperative anemia in patients undergoing TJA influences postoperative periprosthetic joint infection (PJI) and mortality.
QUESTIONS/PURPOSES: We therefore (1) determined the incidence of preoperative anemia in patients undergoing TJA; (2) assessed the possible association between preoperative anemia and subsequent PJI; and (3) explored the relationship between preoperative anemia with postoperative mortality.
METHODS: We identified 15,722 patients who underwent TJA from January 2000 to June 2007. Anemia was defined as hemoglobin < 12 g/dL in women and hemoglobin < 13 g/dL in men. We determined the effect of preoperative anemia, demographics, and comorbidities on postoperative complications.
RESULTS: Of the 15,222 patients, 19.6% presented with preoperative anemia. PJI occurred more frequently in anemic patients at an incidence of 4.3% in anemic patients compared with 2% in nonanemic patients. Thirty-day (0.4%), 90-day (0.6%), and 1-year (1.8%) mortality rates were not higher in patients with preoperative anemia. Forty-four percent of anemic patients received an allogenic transfusion compared with only 13.4% of nonanemic patients. Anemic patients had increased hospital stays averaging 4.3 days compared with 3.9 days in nonanemic patients. Anemia did not predict cardiac complications.
CONCLUSION: Our data demonstrate that preoperative anemia is associated with development of subsequent PJI. Preoperative anemia was not associated with 30-day, 60-day, or 1-year mortality in this cohort.
LEVEL OF EVIDENCE: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Max Greenky; Kishor Gandhi; Luis Pulido; Camilo Restrepo; Javad Parvizi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-14     Completed Date:  2012-11-19     Revised Date:  2013-10-11    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2695-701     Citation Subset:  AIM; IM    
The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.
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MeSH Terms
Anemia / complications*,  epidemiology*
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Hip Prosthesis / adverse effects*
Knee Prosthesis / adverse effects*
Middle Aged
Prosthesis-Related Infections / epidemiology,  etiology*
Retrospective Studies
Time Factors
Comment In:
Z Orthop Unfall. 2012 Dec;150(6):563   [PMID:  23418637 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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