Association of preoperative anemia and increased risk of blood transfusion and length of hospital stay in adults undergoing hip and knee arthroplasty: An observational study in a single tertiary center

Duarte, Gustavo de Carvalho; Catanoce, Aguinaldo Pereira; Zabeu, José Luiz Amim; Ribeiro, Gustavo Meirelles; Moschen, Mariangela; Oliveira, Nathália Aparecida Gonçalves; Langhi, Dante Mário; Júnior, José Francisco Comenalli Marques; Mendrone‐Júnior, Alfredo

doi:10.1002/hsr2.448

Cited by 11 publications

(5 citation statements)

References 16 publications

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“…Despite the high proportion of patients (38.8%) who had anemia in our study, only 17.1% had blood transfusion. This shows that our people tolerate anemia a lot even in surgery as has been shown earlier [2]. A significant number of the raw data showed preponderance of emergency surgeries for which pre-operative transfusion for anemia correction was not feasible.…”

Section: Discussionsupporting

confidence: 62%

“…It is diagnosed as a hemoglobin concentration of less than 11g/dl and 12g/dl in pregnant and non-pregnant women respectively [1].However, Nigerian women with hemoglobin levels between 10g/dl and 11g/dl go through pregnancy and surgeries without any apparent ill effects. Thus in practice, only anemia with hemoglobin levels lower than 10g/dl (packed cell volume, PCV of 30%) is deemed worthy of further investigations and treatment in our environment [2].Itis a common feature in patients presenting for major surgeries and considered an independent risk factor associated with adverse outcome [3,4].Pre-operative anemia was found to be common and equal between genders (39.5%) and associated with a 5-fold increase in the odds of post-operative mortality [5]. In the developing countries of sub-Saharan Africa where there is a high rate of poverty and illiteracy anemia is common.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of pre-operative anemia and associated blood transfusion among obstetrics & gynecological patients in Enugu

Onyekpa¹,

Odugu²,

Onah³

2022

World J. Adv. Res. Rev.

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Background: One of the major preparations before any surgery is to ensure that the patient has adequate blood levels. Anemia, according to the WHO is a common condition in which the number of red cells (and consequently their oxygen carrying capacity) is insufficient to meet the body’s physiological needs. It is diagnosed as hemoglobin concentration of less than 11g/dl and 12g/dl in pregnant and non-pregnant women respectively. However, Nigerian women with hemoglobin levels between 10g/dl and 11g/dl go through pregnancy and surgeries without any apparent ill effects. Aim: To determine the prevalence of pre-operative anemia and associated transfusion among gynecological and obstetric surgical patients in a tertiary hospital Materials & Methods: This a retrospective study of 596 patients who had surgeries in the obstetric and gynecological department of ESUT in 2021 due to various obstetric or gynecological indications. Data was collected with a structured proforma and analyzed using Statistical Package for Social Sciences computer software for Windows version 20.0 presented in tables, charts, means, frequencies and percentages. Results: The results of the data analysis are presented in the tables below. Table 1 showed the distribution of the patients according to their age, marital status and occupation. Majority of the patients,209(35%) were above 36 years whereas 141(23.7%) were less than 25 years. Four hundred and three (67.7%) were married whereas 51(8.6) were widowed. Of all 320(53.7) were self-employed whereas 115(19.3%) were unemployed.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Prevalence of pre-operative anemia and associated blood transfusion among obstetrics & gynecological patients in Enugu

Onyekpa¹,

Odugu²,

Onah³

2022

World J. Adv. Res. Rev.

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“…[54][55][56][57][58] Preoperative anemia is a significant risk factor for both incidence and volume of perioperative blood transfusion. 59 ID anemia is associated with low birth weight and long-term cognitive defects in children lasting up to 18 years of age. 60 Because anemia is common, it is often considered benign and therefore neglected.…”

Section: Anemia With and Without Idmentioning

confidence: 99%

“…Anemia negatively impacts patient morbidity, mortality, length of stay, infection risk, and disease progression 54-58. Preoperative anemia is a significant risk factor for both incidence and volume of perioperative blood transfusion 59. ID anemia is associated with low birth weight and long-term cognitive defects in children lasting up to 18 years of age 60.…”

Section: Anemia With and Without Idmentioning

confidence: 99%

Patient Blood Management as an Emerging Concept in Quality

Ozawa,

Ozawa-Morriello,

Rock

et al. 2023

Journal of Nursing Care Quality

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Background: Transfusion of blood components has long been considered lifesaving therapy. While blood transfusion may be clinically indicated as a treatment option for some patients, the benefits of transfusion in asymptomatic, hemodynamically stable patients are questionable. Problem: Blood component transfusion is routinely used as a default therapy when not clinically indicated, increasing the risk of poor patient outcomes, adverse events, pressures on blood supply and availability, and increased health care costs. Approach: Nurses have the responsibility to advocate for patients and reduce/avoid unnecessary blood transfusion through the implementation of patient blood management (PBM). The PBM paradigm includes treatment of anemia, minimizing blood loss and bleeding, optimization of coagulation, and employing true patient-centered decision making. Conclusions: PBM should become the standard of care with the goal of improving health care quality and patient outcomes while using the multidisciplinary team for its implementation. As advocates for their patients, nurses can play a major role in the development, implementation, and promotion of PBM.

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“…Of note, this effort has resulted in the identification of several patient‐associated factors including previous hip surgery, patient non‐compliance, neuromuscular and cognitive disorders, smoking/chronic obstructive pulmonary disease (COPD), ASA class of 3 to 5, fracture, elevated creatinine (Cr), age ≥ 80 years, chronic steroid use, longer operative duration, and general anesthesia [7]. Additionally, several patient‐associated risk factors have been shown to affect overall patient outcomes in THA, including frailty, age, malnourishment, and medical comorbidities (e.g., anemia, chronic kidney disease [CKD]) but a direct relationship with post‐operative hip dislocation rate has either not been investigated or has not been consistently demonstrated across studies [8, 9]. For example, a previous study has concluded an increased risk of mortality and perioperative complications in primary and revision hip arthroplasty patients [10].…”

Section: Introductionmentioning

confidence: 99%

Preoperative demographics and laboratory markers may be associated with early dislocation after total hip arthroplasty

Lung,

Donnelly,

Callan

et al. 2023

J. exp. orthop.

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Purpose The purpose of this study was to identify modifiable medical comorbidities, laboratory markers and flaws in perioperative management that increase the risk of acute dislocation in total hip arthroplasty (THA) patients. Methods All THA with primary indications of osteoarthritis from 2007 to 2020 were queried from the National Surgical Quality Improvement Program (NSQIP) database. Demographic data, preoperative laboratory values, recorded past medical history, operative details as well as outcome and complication information were collected. The study population was divided into two cohorts: non-dislocation and dislocation patients. Statistics were performed to compare the characteristics of both cohorts and to identify risk factors for prosthetic dislocation (α < 0.05). Results 275,107 patients underwent primary THA in 2007 to 2020, of which 1,258 (0.5%) patients experienced a prosthetic hip dislocation. Demographics between non-dislocation and dislocation cohorts varied significantly in that dislocation patients were more likely to be female, older, with lower body mass index and a more extensive past medical history (all p < 0.05). Moreover, hypoalbuminemia and moderate/severe anemia were associated with increased risk of dislocation in a multivariate model (all p < 0.05). Finally, use of general anesthesia, longer operative time, and longer length of hospital stay correlated with greater risk of prosthetic dislocation (all p < 0.05). Conclusions Elderly female patients and patients with certain abnormal preoperative laboratory values are at risk for sustaining acute dislocations after index THA. Careful interdisciplinary planning and medical optimization should be considered in high-risk patients as dislocations significantly increase the risk of sepsis, cerebral vascular accident, and blood transfusions on readmission.

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Association of preoperative anemia and increased risk of blood transfusion and length of hospital stay in adults undergoing hip and knee arthroplasty: An observational study in a single tertiary center

Cited by 11 publications

References 16 publications

Prevalence of pre-operative anemia and associated blood transfusion among obstetrics & gynecological patients in Enugu

Prevalence of pre-operative anemia and associated blood transfusion among obstetrics & gynecological patients in Enugu

Patient Blood Management as an Emerging Concept in Quality

Preoperative demographics and laboratory markers may be associated with early dislocation after total hip arthroplasty

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