Fatores preditivos de hemotransfusão após artroplastia total de joelho

Mozella, Alan de Paula; Cobra, Hugo Alexandre de Araújo Barros; Duarte, Maria Eugênia Leite

doi:10.1055/s-0040-1715511

Cited by 1 publication

(1 citation statement)

References 24 publications

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“…Kim et al [ 13 ] reported that preoperative Hb level (OR 2.25, 95% CI [1.64–3.10]) was an independent predictor for transfusion after total knee arthroplasty. Similarly, Mozella et al [ 14 ] reported that preoperative Hb levels ≤ 123 g/L is an independent predictor for postoperative blood transfusion after the same surgery. Similar to these studies, the optimal cutoff value of preoperative Hb in our study was 121.5 g/L.…”

Section: Discussionmentioning

confidence: 93%

Clinical outcomes and prediction nomogram model for postoperative hemoglobin < 80 g/L in patients following primary lumbar interbody fusion surgery

Xiong

Liu

et al. 2023

J Orthop Surg Res

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Objective To analyze the association between different postoperative hemoglobin (Hb) levels and postoperative outcomes in patients who have undergone primary lumbar interbody fusion, and to investigate the risk factors and establish a predictive nomogram mode for postoperative Hb < 80 g/L. Methods We retrospectively analyzed 726 cases who underwent primary lumbar interbody fusion surgery between January 2018 and December 2021in our hospital. All patients were divided into three groups according to the postoperative Hb levels (< 70 g/L, 70–79 g/L, ≥ 80 g/L). The postoperative outcomes among the three groups were compared, and the risk factors for postoperative Hb < 80 g/L were identified by univariate and multivariable logistic regression analysis. Based on these independent predictors, a nomogram model was developed. Predictive discriminative and accuracy ability of the predicting model was assessed using the concordance index (C-index) and calibration plot. Clinical application was validated using decision curve analysis. Internal validation was performed using the bootstrapping validation. Results Patients with postoperative Hb < 80 g/L had higher rates of postoperative blood transfusion, a greater length of stay, higher rates of wound complications, and higher hospitalization costs than those with postoperative Hb ≥ 80 g/L. Preoperative Hb, preoperative platelets, fusion segments, body mass index, operation time, and intraoperative blood loss independently were associated with postoperative Hb < 80 g/L. Intraoperative blood salvage was found to be a negative predictor for postoperative Hb < 80 g/L (OR, 0.21 [95% CI 0.09–0.50]). The area under the curve of the nomogram model was 0.950. After internal validations, the C-index of the model was 0.939. The DCA and calibration curve suggested that the nomogram model had a good consistency and clinical utility. Conclusions Postoperative Hb < 80 g/L in patients following primary lumbar interbody fusion surgery increased blood transfusions requirement and was independently associated with poor outcomes. A novel nomogram model was established and could conveniently predict the risk of postoperative Hb < 80 g/L in patients after this type of surgery.

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Section: Discussionmentioning

confidence: 93%