Blood Transfusion Practices in Total Joint Arthroplasties in Jamaica

Abstract

BackgroundMajor blood loss usually occurs in both hip and knee arthroplasty, frequently leading to the need for blood transfusion. This study was performed to determine blood transfusion rates and analyze the factors which affected the need for blood transfusion in patients who underwent primary unilateral total knee and hip arthroplasties at the University Hospital of the West Indies, Jamaica.MethodsA prospective study of 118 patients who underwent unilateral total knee and total hip arthroplasties between January 2004 and July 2009 was undertaken. Data collected was analyzed using Microsoft Excel 2008, SPSS version 12 and Stata version 7.0.ResultsOf the 118 patients, 90 (70%) were females. Mean ± standard deviation (SD) age was 65.2 ± 11.5 years (range 32 - 85 years). Osteoarthritis accounted for the majority (88%) of arthroplasties. Mean ± SD estimated blood loss for all arthroplasties was 1195.0 ± 855.6 ml (range 100 - 6000 ml). Mean ± SD duration of surgery for all joint arthroplasties was 226.1 ± 63.5 minutes (range 110 - 392 minutes). Mean ± SD preoperative hemoglobin was 12.09 g/dl (range 7.3 - 15.6 g/dl). Average body mass index was 28.9 kg/m2 (range 17.9 - 68.3 kg/m2). Seventy-five (64%) patients were transfused and of these, 44 patients received allogenic blood only; 20 patients received autologous blood only, and eleven patients received both allogenic and autologous blood. The overall blood transfusion rate was 63%.ConclusionIn our study, the multivariate analysis showed a significant relationship (p = 0.000) only between postoperative transfusion and the estimated blood loss.KeywordsBlood transfusion practices; Total joint arthroplasties

Revision Total Hip Arthroplasty in Jehovah’s Witnesses at a Public Hospital: Practical Recommendations for a Low-Resource Setting

“…In addition to this, the absence of a blood management protocol has resulted in a wide variability of transfusion practices following joint replacement [ 16 ]. The only study from the Caribbean that attempted to address this issue reported a 63% blood transfusion rate following primary arthroplasty [ 17 ]. Limited blood availability together with high transfusion rates has prompted a search for more innovative and cost-effective methods to reduce the need for blood during arthroplasty.…”