Differences in total blood loss and transfusion rate between different indications for shoulder arthroplasty

Malcherczyk, Dominik; Hack, Juliane; Klasan, Antonio; Abdelmoula, Asma; Heyse, Thomas J.; Greene, Brandon; El-Zayat, Bilal Farouk

doi:10.1007/s00264-018-4047-z

Cited by 15 publications

(15 citation statements)

References 18 publications

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“…The higher rates of transfusion in fracture patients was previously thought to be in part a result of reduced surgical preparation time compared to patients undergoing elective primary SA. 18 Our findings dispute this claim since patients with both acute and chronic fractures had increased transfusion rates despite sufficient surgical preparation times in chronic fracture patients. More research must be conducted to identify what causes fracture patients to be at a higher risk for transfusion even after the initial insult has presumably healed.…”

Section: Discussioncontrasting

confidence: 56%

“…Clinical factors such as preoperative hemoglobin levels impact the risk for transfusion. [14][15][16]18 To our knowledge, this is the first study to investigate differences in transfusion rates and preoperative hemoglobin levels between multiple primary SA indications including OA, RCA, acute fracture ( 4 weeks old), chronic fracture ( > 4 weeks old), as well as for various revision indications including with and without active PJI.…”

Section: Discussionmentioning

confidence: 99%

“…[18][19][20] Two recent studies have demonstrated higher transfusion rates following revision SA (35.5%) compared to primary SA (12.6%), with arthroplasty for fracture having the greatest transfusion risk, ranging from 27% to 33%. 7,18 Other previously investigated risk factors for transfusion following SA include low preoperative hemoglobin (<13 g/dL), higher intraoperative blood loss, use of vitamin K antagonists, and humeral cement fixation. [14][15][16][17] Despite these findings, the effect of SA procedure and other patient-derived factors such as old age, sex, and medical comorbidities on transfusion risk are inconsistently described in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…13 Multiple previous studies have investigated blood loss and the risk of requiring transfusion following SA, 7,[14][15][16][17] and only a small number of studies have explored the effect of surgical indication on transfusion risk. [18][19][20] Two recent studies have demonstrated higher transfusion rates following revision SA (35.5%) compared to primary SA (12.6%), with arthroplasty for fracture having the greatest transfusion risk, ranging from 27% to 33%. 7,18 Other previously investigated risk factors for transfusion following SA include low preoperative hemoglobin (<13 g/dL), higher intraoperative blood loss, use of vitamin K antagonists, and humeral cement fixation.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for postoperative blood transfusion after shoulder arthroplasty

et al. 2021

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Purpose To identify the effect of surgical indication, patient factors, and perioperative characteristics on transfusion after shoulder arthroplasty (SA). Methods Shoulder arthroplasties for osteoarthritis (OA) ( N = 47), rotator cuff arthropathy (RCA) ( N = 50), fracture ( N = 76), revision ( N = 66), and periprosthetic joint infection (PJI) ( N = 35) performed at a single institution during a 6-year period were included. All other indications were excluded. Patient-based and surgical risk factors, including surgical indication, for postoperative allogeneic red blood cell transfusion were assessed with multivariate logistic regression analysis. Results A total of 274 SAs were included; transfusions were performed in 2% (2/97) of primary SAs for OA or RCA. Increased transfusion rates occurred in PJI (23%, p = 0.0006) and fracture (18%, p = 0.0018) cases. The mean preoperative hemoglobin (Hgb) was 12.2 ± 2.2 with PJI, 12.0 ± 2.1 with fracture, and 13.3 ± 1.6 g/dL for all other SAs. Independent risk factors for transfusion included lower preoperative hemoglobin ( p < 0.001), PJI indication ( p = 0.008), and fracture indication ( p = 0.02), with no difference for fracture greater or less than 4 weeks old ( p = 0.53). Conclusion Risk factors for allogeneic red blood cell transfusion after SA were low preoperative hemoglobin and procedures for PJI or fracture. Level of Evidence: Level III, retrospective case-control study

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for postoperative blood transfusion after shoulder arthroplasty

et al. 2021

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“…Recently, XU et al identified that coronary heart disease is one of the risk factors for transfusion in patients following total joint arthroplasty [24]. In addition, Malcherczyk et al [25] reported that coronary heart disease is a risk factor for postoperative blood transfusion in patients with shoulder arthroplasty. However, the potential mechanism between coronary heart disease and transfusion remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram to predict perioperative blood transfusion in patients undergoing total knee arthroplasty

Wang

Shen

et al. 2020

BMC Musculoskelet Disord

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Background: The need for a transfusion is one of the adverse events following total knee arthroplasty (TKA), and accurately predicting this need remains challenging for arthroplasty surgeons. The purpose of the present research is to study the preoperative predictors of transfusion risk in patients following TKA and develop a nomogram. Methods: The nomogram was developed based on a training set of 5402 patients who underwent TKA at the Affiliated Hospital of Qingdao University between September 2013 and November 2018. The independent predictors of transfusion were identified by univariate, LASSO, and binary logistic regression analyses. Then, a nomogram was established based on these independent predictors. The area under the curve (AUC), calibration curve, and decision curve analysis (DCA) were selected to evaluate the nomogram. The results were validated using an independent set of 1116 patients who underwent TKA between December 2018 and September 2019. In addition, we also carried out subgroup analyses in the training and testing sets based on the independent predictors. Results: Five independent predictors were identified by multivariate analysis and were used to establish the nomogram. The AUCs of the nomogram were 0.884 (95% CI: 0.865-0.903) and 0.839 (95% CI, 0.773-0.905) in the training and testing sets, respectively. In both the training and testing sets, the calibration curve indicated that the prediction by the nomogram was highly consistent with the actual observation, and the DCA indicated that the nomogram had a favorable level of clinical usefulness. In addition, the AUC of the nomogram was significantly higher than the AUC of any independent predictor for predicting transfusion risk following TKA, and the subgroup analysis showed good performance in 20 subgroups. Conclusion: Lower preoperative Hb levels, simultaneous bilateral TKA, lower BMI, older age, and coronary heart disease were identified as independent predictors of postoperative transfusion in patients following TKA. A nomogram incorporating the above five predictors could accurately predict the transfusion risk.

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Sex dimorphisms in coagulation: Implications in trauma‐induced coagulopathy and trauma resuscitation

Coleman,

Gumina,

Hund

et al. 2024

American J Hematol

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Trauma‐induced coagulopathy (TIC) is one of the leading causes of preventable death in injured patients. Consequently, it is imperative to understand the mechanisms underlying TIC and how to mitigate this mortality. An opportunity for advancement stems from the awareness that coagulation demonstrates a strong sex‐dependent effect. Females exhibit a relative hypercoagulability compared to males, which persists after injury and confers improved outcomes. The mechanisms underlying sex dimorphisms in coagulation and its protective effect after injury have yet to be elucidated. This review explores sex dimorphisms in enzymatic hemostasis, fibrinogen, platelets, and fibrinolysis, with implications for resuscitation of patients with TIC.

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Differences in total blood loss and transfusion rate between different indications for shoulder arthroplasty

Abstract: The most important susceptible factor that affects the TBL is the surgery time. Transfusion rates are higher in patients with fracture arthroplasty than after primary arthroplasty.

Cited by 15 publications

References 18 publications

Risk factors for postoperative blood transfusion after shoulder arthroplasty

Risk factors for postoperative blood transfusion after shoulder arthroplasty

Development and validation of a nomogram to predict perioperative blood transfusion in patients undergoing total knee arthroplasty

Sex dimorphisms in coagulation: Implications in trauma‐induced coagulopathy and trauma resuscitation

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