J Arthroplasty. 2021 Dec 6:S0883-5403(21)00904-9. doi: 10.1016/j.arth.2021.11.039. Online ahead of print.
ABSTRACT
BACKGROUND: There is a paucity of data on blood loss and the risk of allogeneic blood transfusion after simultaneous bilateral total hip arthroplasty (SBTHA) with contemporary blood management including neuraxial anesthesia, routine tranexamic acid (TXA) use, and a restrictive transfusion protocol. As such, we sought to determine the in-hospital outcomes of SBTHA, specifically analyzing blood loss and the rate and risk factors for transfusion.
METHODS: We identified 191 patients that underwent SBTHA at a single institution from 2016-2019. No drains were utilized and no patients donated blood preoperatively. Mean age was 59 years with 96 females (50.3%). The surgical approach was posterior in 138 (72.3%) and direct anterior in 53 (27.7%) patients. We analyzed blood loss, the rate of allogeneic blood transfusions, and in-hospital thromboembolic complications. We analyzed risk factors for transfusion with a logistic regression analysis.
RESULTS: Twenty-two patients (11.5%) underwent allogeneic blood transfusion. All transfused patients were female. Univariate analysis revealed female sex as a transfusion risk factor since it had statistically significant higher proportion in the transfusion group than the non-transfusion group (100% vs. 43.5%, respectively, p<0.001). We did not identify any other singular significant risk factors for transfusion in a multivariable regression analysis. However, females with a preoperative Hgb <12 had an elevated risk of transfusion at 37.5% (15/40 patients).
CONCLUSION: With contemporary perioperative blood management protocols, there is a relatively low (11.5%) risk of a blood transfusion after SBTHA. Females with a lower preoperative Hgb (<12 g/dL) had the highest risk of transfusion at 37.5%.
PMID:34883254 | DOI:10.1016/j.arth.2021.11.039
