Predictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty

Abstract Endoprosthetic surgery can lead to relevant blood loss resulting in red blood cell (RBC) transfusions. This study aimed to identify risk factors for blood loss and RBC transfusion that enable the prediction of an individualized transfusion probability to guide preoperative RBC provision and...

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Autores principales:	Christina Pempe, Robert Werdehausen, Philip Pieroh, Martin Federbusch, Sirak Petros, Reinhard Henschler, Andreas Roth, Christian Pfrepper
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f9398ff7207340dba006ef884c409f1c
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spelling	oai:doaj.org-article:f9398ff7207340dba006ef884c409f1c2021-12-02T16:23:14ZPredictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty10.1038/s41598-021-82779-z2045-2322https://doaj.org/article/f9398ff7207340dba006ef884c409f1c2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-82779-zhttps://doaj.org/toc/2045-2322Abstract Endoprosthetic surgery can lead to relevant blood loss resulting in red blood cell (RBC) transfusions. This study aimed to identify risk factors for blood loss and RBC transfusion that enable the prediction of an individualized transfusion probability to guide preoperative RBC provision and blood saving programs. A retrospective analysis of patients who underwent primary hip or knee arthroplasty was performed. Risk factors for blood loss and transfusions were identified and transfusion probabilities computed. The number needed to treat (NNT) of a potential correction of preoperative anemia with iron substitution for the prevention of RBC transfusion was calculated. A total of 308 patients were included, of whom 12 (3.9%) received RBC transfusions. Factors influencing the maximum hemoglobin drop were the use of drain, tranexamic acid, duration of surgery, anticoagulation, BMI, ASA status and mechanical heart valves. In multivariate analysis, the use of a drain, low preoperative Hb and mechanical heart valves were predictors for RBC transfusions. The transfusion probability of patients with a hemoglobin of 9.0–10.0 g/dL, 10.0–11.0 g/dL, 11.0–12.0 g/dL and 12.0–13.0 g/dL was 100%, 33.3%, 10% and 5.6%, and the NNT 1.5, 4.3, 22.7 and 17.3, while it was 100%, 50%, 25% and 14.3% with a NNT of 2.0, 4.0, 9.3 and 7.0 in patients with a drain, respectively. Preoperative anemia and the insertion of drains are more predictive for RBC transfusions than the use of tranexamic acid. Based on this, a personalized transfusion probability can be computed, that may help to identify patients who could benefit from blood saving programs.Christina PempeRobert WerdehausenPhilip PierohMartin FederbuschSirak PetrosReinhard HenschlerAndreas RothChristian PfrepperNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Christina Pempe Robert Werdehausen Philip Pieroh Martin Federbusch Sirak Petros Reinhard Henschler Andreas Roth Christian Pfrepper Predictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty
description	Abstract Endoprosthetic surgery can lead to relevant blood loss resulting in red blood cell (RBC) transfusions. This study aimed to identify risk factors for blood loss and RBC transfusion that enable the prediction of an individualized transfusion probability to guide preoperative RBC provision and blood saving programs. A retrospective analysis of patients who underwent primary hip or knee arthroplasty was performed. Risk factors for blood loss and transfusions were identified and transfusion probabilities computed. The number needed to treat (NNT) of a potential correction of preoperative anemia with iron substitution for the prevention of RBC transfusion was calculated. A total of 308 patients were included, of whom 12 (3.9%) received RBC transfusions. Factors influencing the maximum hemoglobin drop were the use of drain, tranexamic acid, duration of surgery, anticoagulation, BMI, ASA status and mechanical heart valves. In multivariate analysis, the use of a drain, low preoperative Hb and mechanical heart valves were predictors for RBC transfusions. The transfusion probability of patients with a hemoglobin of 9.0–10.0 g/dL, 10.0–11.0 g/dL, 11.0–12.0 g/dL and 12.0–13.0 g/dL was 100%, 33.3%, 10% and 5.6%, and the NNT 1.5, 4.3, 22.7 and 17.3, while it was 100%, 50%, 25% and 14.3% with a NNT of 2.0, 4.0, 9.3 and 7.0 in patients with a drain, respectively. Preoperative anemia and the insertion of drains are more predictive for RBC transfusions than the use of tranexamic acid. Based on this, a personalized transfusion probability can be computed, that may help to identify patients who could benefit from blood saving programs.
format	article
author	Christina Pempe Robert Werdehausen Philip Pieroh Martin Federbusch Sirak Petros Reinhard Henschler Andreas Roth Christian Pfrepper
author_facet	Christina Pempe Robert Werdehausen Philip Pieroh Martin Federbusch Sirak Petros Reinhard Henschler Andreas Roth Christian Pfrepper
author_sort	Christina Pempe
title	Predictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty
title_short	Predictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty
title_full	Predictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty
title_fullStr	Predictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty
title_full_unstemmed	Predictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty
title_sort	predictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/f9398ff7207340dba006ef884c409f1c
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Predictors for blood loss and transfusion frequency to guide blood saving programs in primary knee- and hip-arthroplasty

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