Psychopharmacologic treatment and blood transfusion in fast‐track total hip and knee arthroplasty

Gylvin, Silas Hinsch; Jørgensen, Christoffer Calov; Fink-Jensen, Anders; Johansson, Pär I.; Kehlet, Henrik

doi:10.1111/trf.13992

Cited by 13 publications

(6 citation statements)

References 49 publications

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“…However, our study included a relatively large sample size of patients with AS. Second, there was no information on bone mineral density or selective serotonin reuptake inhibitor utilization in the medical records, which may have also affected the results [ 15 , 40 , 41 ]. Intraoperative blood loss was estimated by the surgeon, which may have caused data inaccuracy.…”

Section: Discussionmentioning

confidence: 99%

Predisposing factors for allogeneic blood transfusion in patients with ankylosing spondylitis undergoing primary unilateral total hip arthroplasty: a retrospective study

et al. 2023

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Background The transfusion rate is relatively high in patients with ankylosing spondylitis (AS) undergoing total hip arthroplasty (THA). However, relevant studies focusing on the predisposing factors for transfusion with a large sample size are lacking. This study aimed to investigate the incidence of and risk factors for allogeneic blood transfusion in patients with AS undergoing primary unilateral THA. Methods This retrospective study included 331 patients with AS who underwent primary unilateral THA between 2011 and 2021. Relevant parameters were collected through a chart review. Multivariate logistic regression analysis was conducted to identify possible factors associated with perioperative allogeneic blood transfusion. Results A total of 113 (34.1%) patients received perioperative allogeneic blood transfusions. Factors related to receiving an allogeneic blood transfusion included prolonged operative duration (odds ratio [OR] per 10 min = 1.139, P = 0.047), increased estimated intraoperative blood loss (OR per 100 mL = 1.348, P < 0.001), and increased postoperative drainage volume (OR per 100 mL = 1.235, P = 0.024). A higher body mass index (BMI) (OR = 0.914, P = 0.012), perioperative tranexamic acid (TXA) use (OR = 0.166, P < 0.001), and a higher preoperative hemoglobin level (OR per 1 g/dL = 0.744, P = 0.004) decreased the risk of transfusion. Conclusions In patients with AS undergoing THA, prolonged operative duration, increased estimated intraoperative blood loss, and increased postoperative drainage volume were found to be risk factors for transfusion, whereas a higher BMI, perioperative TXA use, and a higher preoperative hemoglobin level were protective factors. These results may aid in developing a better perioperative management strategy, ultimately reducing the need for transfusion.

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Section: Discussionmentioning

confidence: 99%

Predisposing factors for allogeneic blood transfusion in patients with ankylosing spondylitis undergoing primary unilateral total hip arthroplasty: a retrospective study

et al. 2023

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“…Previous studies concluded that hip surgeries carried a higher risk of blood transfusion than did knee surgeries. 12,25 In this study, we found that patients who had hip fracture repair were more likely to be older (80 years) than those who had hip replacement (64 years). According to our multiple logistic regression, age was one of the risk factors for requiring ≥ 2 units of PRBCs transfusion (OR, 1.08; 95% CI, 1.04-1.13, P < 0.0001).…”

Section: Discussionmentioning

confidence: 63%

Evaluation of Bleeding in Orthopedic Surgery With Perioperative Use of Serotonergic Antidepressants

Yang

Seifert

2022

Ann Pharmacother

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Background: The use of serotonergic antidepressants (SADs) is associated with an increase in bleeding, and their exposure during the perioperative period increases the potential bleeding risk in patients undergoing surgical operations. Objective: The purpose of this study was to compare the rates of bleeding between patients on perioperative SADs and those not on SADs in patients undergoing orthopedic surgical procedures. Methods: A retrospective cohort study was conducted with patients who were admitted to a single tertiary care county teaching hospital for orthopedic surgery. Outcomes evaluated were requirements of ≥ 2 units of packed red blood cells (PRBCs) and length of hospital stay for those requiring ≥ 2 units of PRBCs. Results: Of 273 patients, a significantly higher percentage of patients who received SADs required ≥ 2 units of PRBCs (19.3% vs 6.9%; P = 0.0049). Patients who required transfusion had a higher median (interquartile range [IQR]) age (79 [64-84.6] vs 65 [59-75]; P < 0.0001). The risk of requiring ≥ 2 units of PRBCs transfusion was greater for individuals having an anemia comorbidity (odds ratio [OR], 4.55; 95% CI, 1.95-10.62, P = 0.0004). Patients who required ≥ 2 units of PRBCs had a longer median hospital stay than those who did not receive ≥ 2 units of PRBCs (8 [5-10.1] vs 4 [3-5]; P < 0.0001). Conclusion and Relevance: Receiving SADs in the perioperative period is associated with a higher transfusion requirement in patients undergoing orthopedic surgery. Clinicians should be aware of this increased risk for patients who are taking SADs while undergoing surgical procedures.

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“…In this systematic review, data quality issues were the most commonly reported barriers, followed by the lack of data standards and limited technical capabilities. Although Denmark has a developed health data infrastructure, numerous identified projects described that data quality problems still affect health services, public health and research datasets [38, 79, 86, 98, 119, 143, 149, 151]. This is confirmed by other studies, such as a review on the Danish National Patient Registry (DNRP) where the authors concluded that data incompleteness and heterogeneous validation methods of data limited the research potential of this registry [377].…”

Section: Discussionmentioning

confidence: 87%

Factors influencing harmonized health data collection, sharing and linkage in Denmark and Switzerland: A systematic review

Geneviève

Martani²,

Mallet³

et al. 2019

PLoS ONE

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IntroductionThe digitalization of medicine has led to a considerable growth of heterogeneous health datasets, which could improve healthcare research if integrated into the clinical life cycle. This process requires, amongst other things, the harmonization of these datasets, which is a prerequisite to improve their quality, re-usability and interoperability. However, there is a wide range of factors that either hinder or favor the harmonized collection, sharing and linkage of health data.ObjectiveThis systematic review aims to identify barriers and facilitators to health data harmonization—including data sharing and linkage—by a comparative analysis of studies from Denmark and Switzerland.MethodsPublications from PubMed, Web of Science, EMBASE and CINAHL involving cross-institutional or cross-border collection, sharing or linkage of health data from Denmark or Switzerland were searched to identify the reported barriers and facilitators to data harmonization.ResultsOf the 345 projects included, 240 were single-country and 105 were multinational studies. Regarding national projects, a Swiss study reported on average more barriers and facilitators than a Danish study. Barriers and facilitators of a technical nature were most frequently reported.ConclusionThis systematic review gathered evidence from Denmark and Switzerland on barriers and facilitators concerning data harmonization, sharing and linkage. Barriers and facilitators were strictly interrelated with the national context where projects were carried out. Structural changes, such as legislation implemented at the national level, were mirrored in the projects. This underlines the impact of national strategies in the field of health data. Our findings also suggest that more openness and clarity in the reporting of both barriers and facilitators to data harmonization constitute a key element to promote the successful management of new projects using health data and the implementation of proper policies in this field. Our study findings are thus meaningful beyond these two countries.

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Psychopharmacologic treatment and blood transfusion in fast‐track total hip and knee arthroplasty

Abstract: Preoperative treatment with SSRIs, OAs, or APs are independent risk factors for blood transfusion in elective fast-track THA and TKA.

Cited by 13 publications

References 49 publications

Predisposing factors for allogeneic blood transfusion in patients with ankylosing spondylitis undergoing primary unilateral total hip arthroplasty: a retrospective study

Predisposing factors for allogeneic blood transfusion in patients with ankylosing spondylitis undergoing primary unilateral total hip arthroplasty: a retrospective study

Evaluation of Bleeding in Orthopedic Surgery With Perioperative Use of Serotonergic Antidepressants

Factors influencing harmonized health data collection, sharing and linkage in Denmark and Switzerland: A systematic review

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