Minorities Are Less Likely to Receive Autologous Blood Transfusion for Major Elective Orthopaedic Surgery

Menendez, Mariano E.; Ring, David

doi:10.1007/s11999-014-3793-5

Cited by 16 publications

(18 citation statements)

References 44 publications

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“…Factors including limited access to care, low health literacy, and a higher prevalence of risky behaviors (e.g. drug and alcohol abuse) may be at the heart of the poorer prognosis associated with underinsured patients and those living in rural areas [32][33][34][35]. It is also possible that these patients were referred to less experienced and less specialized surgeons, or that they were more likely to utilize the ED instead of going to the physician's office for an infection [33,36].…”

Section: Discussionmentioning

confidence: 99%

Surgical site infection in hand surgery

Menendez

Unizony

et al. 2015

International Orthopaedics (SICOT)

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The rates of postoperative acute care visits for surgical site infection after ambulatory hand procedures are low but not negligible-particularly given how common hand surgery is, and the fact that many of these events entail hospitalizations or additional ambulatory procedures. Reasons for the increased risk of acute care visits for infection among publicly insured and rural patients merit additional research.

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Section: Discussionmentioning

confidence: 99%

Surgical site infection in hand surgery

Menendez

Unizony

et al. 2015

International Orthopaedics (SICOT)

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“…Few studies have assessed the role of race and ethnicity on the incidence of intraoperative complications. Menendez and Ring 16 analyzed the perioperative risks of different racial groups following any major elective orthopedic procedure, as identified by the NIS, the largest allpayer inpatient database in the country containing discharge records from over 1,000 hospitals (n=3.5 million patients). They found that Hispanics were less likely than Caucasians to receive a blood transfusion during a THA (OR, 0.75; 95% CI, 0.69 to 0.82; P<.001) or a TKA (OR, 0.71; 95% CI, 0.67 to 0.75).…”

Section: Intraoperative Complicationsmentioning

confidence: 99%

“…1 Multiple studies have shown that racial minorities undergo TJA much less frequently than Caucasians. [8][9][10][11][12][13][14][15] Furthermore, studies have shown higher complication rates among these ethnic minorities, [16][17][18][19][20][21][22][23][24] and some have even showed an association between disparities and patient-reported and functional outcomes. [25][26][27][28] The following review will highlight more specific details of these disparities and outcome differences.…”

mentioning

confidence: 99%

Racial Disparities in Lower Extremity Arthroplasty Outcomes and Use

et al. 2015

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Race-associated disparities often occur in patients who undergo lower extremity total joint arthroplasty (TJA). Although it is imperative to elucidate and describe the disparities in race and ethnicity that may influence patient perception, satisfaction, and surgical outcomes, there is a paucity of reports detailing the nature of potential racial disparities in TJA. Therefore, the purpose of this review was to examine racial and ethnic disparities in the (1) physician-patient relationship; (2) use of TJA; (3) intraoperative and 30-day postoperative complications; and (4) patient-reported outcomes. Although there are limited studies that evaluated this topic, it has been shown that there are race-specific differences in physician-patient relationships. Specifically, African American patients report lower satisfaction rates in communication with their physician than their Caucasian counterparts and physicians were more apt to describe African Americans as less "medically cooperative." The majority of the studies the authors found regarding TJA use indicated that African Americans and Hispanics were less likely to undergo lower extremity TJA than Caucasians. Furthermore, racial minorities may have higher 30-day readmission and intra- and postoperative complication rates compared with Caucasians. Despite these compelling findings, concrete conclusions are difficult to make due to the presence of multiple confounding patient factors, and more studies examining the racial and ethnic disparities in patients with TJA are needed.

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“…Concerning AT, patient's blood can be collected using different strategies among which the most frequently applied are the following ones: 1) preoperative autologous collection/donation (PAD); 2) acute normovolemic hemodilution (ANH); and 3) perioperative blood recovery/salvage (PBR). In addition, the scheme of PBR includes: a) intraoperative blood collection/salvage (IBC) from the surgical field, and b) postoperative blood collection/drainage (PBC) by aspiration 1,[14][15][16][17][18][19][20][21][22] . Independently or combined, these AT-strategies proved to reduce the needs for allogeneic blood in elective surgery.…”

Section: Regardless Of the Implementation Of Different Effective Prevmentioning

confidence: 99%

“…Opinions regarding efficiency of PBC in orthopedic surgery are not unanimous and the following should be taken into consideration: 1) prospect studies to illustrate the benefits of transfusion of "saved" blood; b) make analyses of risks of transfusion of unprocessed blood, taking into special consideration possible contamination of blood with bacteria or chemical agents (e.g. metylmetakrylat) and 3) analysis of cost vs benefit aspects 6,[14][15][16][17][18][19][20][21][22] .…”

Section: Perioperative Blood Recovery/salvagementioning

confidence: 99%