Risk Factors for Transfusions Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

Salt, Elizabeth; Wiggins, Amanda; Rayens, Mary Kay; Brown, Katelyn; Eckmann, Kate; Johannemann, Andrew; Wright, Raymond D.; Crofford, Leslie J.

doi:10.1097/rhu.0000000000000755

Cited by 16 publications

(16 citation statements)

References 26 publications

(71 reference statements)

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“…There are many studies indicating that female patients are at risk for blood transfusions in THA. 5,6,11,12,14 However, Grosflam reported higher blood transfusions in male patients. 15 Contrary, Ogbemudia found that sex is not a predictor for blood transfusions.…”

Section: Discussionmentioning

confidence: 98%

“…7,8 There have been many studies reporting on the risk factors of blood transfusions in total hip arthroplasty. [9][10][11][12] However, there is, to our knowledge, no report on the risk factors for blood transfusions in hemi hip arthroplasty in femoral neck fractures, which are less invasive and generally performed on older aged patients, compared with THA. This study underlines that there were many factors associated with blood transfusions after hemi hip arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to our result, there were many studies stating that: BMI or weight were not predictive factors for blood transfusion. 5,11,14,16 Preoperative hemoglobin levels, or hematocrit, were stated to be strong predictors for blood transfusion. Our study had the same results as previous data, which reported that a lower preoperative hemoglobin level and hematocrit was associated with a higher risk of blood transfusion in THA.…”

Section: Discussionmentioning

confidence: 99%

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Factors for Blood Transfusions Following Hemi Hip Arthroplasty for Patients With Femoral Neck Fracture

Luangwaranyoo

Suksintharanon

Tangadulrat

et al. 2020

Geriatr Orthop Surg Rehabil

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Background: Hemi hip arthroplasty is one treatment option for femoral neck fractures; however, there has been limited evidence on factors associated with blood transfusions following hemi hip arthroplasty. Hence, the aim of this study was to identify the predictors of blood transfusion after hemi hip arthroplasty, which could lead to the establishment of proper guidelines for management protocols. Materials and Methods: This study was a retrospective cohort study, conducted in a single center of 323 femoral neck fracture patients having undergone hemi hip arthroplasty. Peri-operative factors and demographic data were extracted from the electronic medical records, from 2007 to 2019. A predictive model was developed by logistic regression (LR), and adjusted by multivariate logistic regression. Result: One hundred and twenty-six (39%) patients received blood transfusions. On multivariate analysis, those of a female gender (odds ratio (OR) 2.00, p = 0.037), having a body mass index lower than 18.5 kg/m2 (OR 2.40, p = 0.028), lower preoperative hemoglobin levels (OR 0.52, p < 0.001) and given general anesthesia (OR 2.07, p = 0.028) were shown to be significantly associated with a higher risk of requiring a blood transfusion. Conclusion: The authors recommend that preparation of blood components coupled with the utilization of blood conserving methods for high risk patients, as studies have stated, in addition to the consideration of spinal anesthesia; if patients have no contraindication, should be implemented.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Factors for Blood Transfusions Following Hemi Hip Arthroplasty for Patients With Femoral Neck Fracture

Luangwaranyoo

Suksintharanon

Tangadulrat

et al. 2020

Geriatr Orthop Surg Rehabil

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“…All these studies included heterogeneous groups; patients with primary and secondary osteoarthritis, coxarthrosis in the course of rheumatoid arthritis, and others. Some of these conditions could affect perioperative blood loss and the need for blood transfusion [22]. These conditions illustrate why we need more well-prepared multi-centre prospective studies.…”

Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Bartosz¹,

Marczyński

Para

et al. 2020

Preprint

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Background: Several studies have suggested that the use of drains did not improve surgical outcomes after hip replacement. There is still a lack of strict recommendations for drainage use.Methods: Prospective, randomised study was performed. The analysis included 100 patients. Inclusion criteria: idiopathic hip osteoarthritis. Exclusion criteria: secondary coxarthrosis, autoimmune disease, coagulopathy, venous/arterial thrombosis, hepatic/renal insufficiency, cement, or hybrid endoprostheses. Results: We found smaller haematomas in the no-drainage group (9.76 mm vs. 10.33 mm, p = 0.653). The visual analogue scale score was lower in the no-drainage group (5 vs. 6). Less bloodloss in the no-drainage group (1,124 ml vs 1,224 ml, p = 0.59). Two patients had a deep joint infection in the no-drainage group, none in the drainage group.Conclusion: It is noteworthy that two cases of early infections were observed in the no-drainage group, whereas there were no such complications in the drainage group. Further research is warranted to validate our findings.Trial registration: The study was successfully retrospectively registered in Clinicaltrial.gov with identification number: NCT04333264 (03/04/2020). https://clinicaltrials.gov/ct2/show/NCT04333264?term=NCT04333264&draw=2&rank=1

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“…Anemia is the most common comorbidity in patients with rheumatoid arthritis with an estimated prevalence of 33.3 to 59.1% [24-27]. Preoperative anemia may increase the likelihood of allogenic transfusion following total joint arthroplasty, which in turn carries an increased risk of PJI [24-26, 28].…”

Section: Pre-surgical Assessment and Optimizationmentioning

confidence: 99%

Periprosthetic Joint Infection in Patients with Inflammatory Joint Disease: Prevention and Diagnosis

et al. 2018

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Patients with inflammatory arthritis have a higher risk of PJI after TJA; however, there are several preventive, diagnostic, and therapeutic measures that can be optimized to lower the burden of PJI in this population. This manuscript will review the current evidence and clinical practice recommendations that support specific features of preoperative evaluation, perioperative medication management, and surgical planning in inflammatory arthritis patients undergoing TJA. Evidence and recommendations for the diagnosis of PJI in this patient population will also be reviewed. Despite increased research efforts directed towards PJI, specific approaches directed at the inflammatory arthritis patient population remain surprisingly limited. Optimization strategies such as adequately managing disease-modifying medications, treating preoperative anemia, encouraging smoking cessation, and improving weight management are strongly encouraged before entering the perioperative period. If PJI does occur in the inflammatory arthritis patient, establishing the diagnosis is challenging, since guidelines were created from investigations of PJI in primarily patients without inflammatory arthritis. Future prospective research is required to better guide clinicians in preventing and diagnosing PJI in inflammatory arthritis patients undergoing TJA.

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Risk Factors for Transfusions Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

Abstract: Risk factors for the receipt of blood transfusions among RA patients who have undergone total joint arthroplasty were identified.

Cited by 16 publications

References 26 publications

Factors for Blood Transfusions Following Hemi Hip Arthroplasty for Patients With Femoral Neck Fracture

Factors for Blood Transfusions Following Hemi Hip Arthroplasty for Patients With Femoral Neck Fracture

Clinical Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Periprosthetic Joint Infection in Patients with Inflammatory Joint Disease: Prevention and Diagnosis

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Risk Factors for Transfusions Following Total Joint Arthroplasty in Patients With Rheumatoid Arthritis

Abstract: Risk factors for the receipt of blood transfusions among RA patients who have undergone total joint arthroplasty were identified.

Cited by 16 publications

References 26 publications

Factors for Blood Transfusions Following Hemi Hip Arthroplasty for Patients With Femoral Neck Fracture

Factors for Blood Transfusions Following Hemi Hip Arthroplasty for Patients With Femoral Neck Fracture

Clinical&nbsp;Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Periprosthetic Joint Infection in Patients with Inflammatory Joint Disease: Prevention and Diagnosis

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Clinical Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study