Incidence and risk factors for blood transfusion in shoulder arthroplasty

Sperling, John W.; Duncan, Scott F. M.; Cofield, Robert H.; Schleck, Cathy D.; Harmsen, William S.

doi:10.1016/j.jse.2005.03.006

Cited by 61 publications

(65 citation statements)

References 3 publications

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“…Transfusions were more common in older patients in all three studies, but only one study [12] reported increasing age as an independent risk factor. Preoperative hemoglobin was the only risk factor consistently seen across all three studies [12,24,37]. In our study, patients 80 years and older had a lower preoperative hemoglobin than the younger patient group and ultimately required more blood transfusions, but preoperative hemoglobin did not remain a predictor on multivariate analysis.…”

Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 99%

“…Several other studies have examined transfusion rates for patients of all ages undergoing total shoulder arthroplasty [12,24,37]. Sperling et al [37] reported an overall transfusion rate of 8.1% in 407 consecutive primary shoulder arthroplasties (mean age, 65.7 years). Millet et al [24] reported a 25% rate in 124 shoulder arthroplasties (mean age, 63.8 years) that included revision surgeries, whereas Gruson et al [12] reported a 43% rate in 196 shoulder arthroplasties (mean age, 67.2 years) that include revision surgeries and reverse prostheses.…”

Section: Discussionmentioning

confidence: 99%

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Total Shoulder Arthroplasty in Older Patients: Increased Perioperative Morbidity?

Ricchetti

Abboud

Kuntz

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background More elderly patients are becoming candidates for total shoulder arthroplasty with an increase in frequency of the procedure paralleling the rise in other total joint arthroplasties. Controversy still exists, however, regarding the perioperative morbidity of total joint arthroplasty in elderly patients, particularly those 80 years of age and older. Questions/purposes We asked whether perioperative complications and mortality, transfusion requirements, inpatient length of stay, and discharge disposition after total shoulder arthroplasty were similar in patients 80 years and older compared with those in younger patients. MethodsWe retrospectively compared the 90-day complications, mortality, and other perioperative variables after total shoulder arthroplasty in 40 patients (43 shoulders) aged 80 years and older (Group A; mean age, 82 years) with 46 patients (47 shoulders) younger than 70 years (Group B; mean age, 61 years). Results We found no differences in complication rates between Group A and B, including systemic (26% versus 11%) and local (5% versus 9%) complications or major (7% versus 2%) and minor (23% versus 17%) complications. There were no deaths in either group. Group A had an increased transfusion requirement (16% versus 2%) and a decreased number of direct to home discharges (67% versus 98%

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Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Total Shoulder Arthroplasty in Older Patients: Increased Perioperative Morbidity?

Ricchetti

Abboud

Kuntz

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Previous reports have found postoperative complication rates of 2.8% to 3.6% at 30 days with exclusion of transfusion as a complication [10,43]. Bleeding resulting in transfusion has been previously studied as an individual complication in the setting of TSA with transfusion rates ranging from 7% to 43% [15,17,30,37,41]. Low preoperative hemoglobin in the setting of TSA was found to be an independent risk factor for transfusion in a number of studies [15,17,30,41].…”

Section: Introductionmentioning

confidence: 99%

“…Bleeding resulting in transfusion has been previously studied as an individual complication in the setting of TSA with transfusion rates ranging from 7% to 43% [15,17,30,37,41]. Low preoperative hemoglobin in the setting of TSA was found to be an independent risk factor for transfusion in a number of studies [15,17,30,41]. Transfusion poses a small but present risk to patients, increased cost to hospitals and healthcare systems, and has been shown to be a modifiable complication in TKA and THA [13,18,30].…”

Section: Introductionmentioning

confidence: 99%

What Are Risk Factors for 30-day Morbidity and Transfusion in Total Shoulder Arthroplasty? A Review of 1922 Cases

Anthony

Westermann

Gao

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Total shoulder arthroplasty (TSA) is an effective treatment for end-stage glenohumeral joint pathology with good long-term results. Previous descriptions of morbidity and blood transfusion in TSA are limited by preoperative risk factors and postoperative complications considered and single-center studies. Questions/purposes The purpose of this study was to define in a group of patients undergoing TSA (1) the type and incidence of complications; (2) the frequency of and risk factors for both minor and major complications; and (3) the risk factors for bleeding resulting in transfusion. Methods We retrospectively queried the National Surgical Quality Improvement Program database using Current Procedural Terminology billing codes and identified 1922 cases of TSA performed between 2006 and 2011. Postoperative outcomes were divided into one of four categories: any complication, major morbidity (systemic life-threatening event or a substantial threat to a vital organ) or mortality, minor morbidity (localized to the operative upper extremity or not posing a major systemic threat to the patient), or bleeding resulting in transfusion. Univariate and multivariate analyses were then used to identify risk factors for complications.

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Thirty-day complications in rheumatoid patients following total knee arthroplasty

et al. 2015

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Although total knee arthroplasty (TKA) is highly successful for patients with end-stage rheumatoid arthritis (RA), the risks and complications associated with surgery in this cohort are less defined. The objectives of our study were to analyze the demographic and perioperative factors of RA patients that may affect post-TKA outcomes, as well as to assess the 30-day complication rates compared to osteoarthritis patients. We retrospectively evaluated the National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2012 to assess all patients who underwent a primary TKA and had a diagnosis of rheumatoid arthritis (n = 141) or primary knee osteoarthritis (n = 7125). We evaluated and compared the demographic factors, social factors, preoperative factors, operative factors, and postoperative complications. The RA cohort had a lower mean age and body mass index than patients in the OA group. There was also a significantly higher incidence of women and Hispanics in the RA cohort. There was a lower incidence of diabetes and hypertension requiring medication in the rheumatoid cohort, but also a higher incidence of bleeding disorders. The RA cohort had an increased proportion of patients requiring blood transfusions and had a longer mean length of stay. The incidence of pneumonia and postoperative bleeding that required transfusion was also higher in RA patients. Rheumatoid patients had higher rates of wound infections, pulmonary embolisms, and deep vein thrombosis; however, these findings were not significant. Although RA patients with end-stage knee arthritis may benefit from TKA, these patients should be preoperatively optimized to minimize complication risks.

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Incidence and risk factors for blood transfusion in shoulder arthroplasty

Cited by 61 publications

References 3 publications

Total Shoulder Arthroplasty in Older Patients: Increased Perioperative Morbidity?

Total Shoulder Arthroplasty in Older Patients: Increased Perioperative Morbidity?

What Are Risk Factors for 30-day Morbidity and Transfusion in Total Shoulder Arthroplasty? A Review of 1922 Cases

Thirty-day complications in rheumatoid patients following total knee arthroplasty

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