Incidence, Risk Factors, and Nomogram of Transfusion and Associated Complications in Nonfracture Patients following Total Hip Arthroplasty

Abstract

The incidence, risk factors, and associated complications of perioperative transfusion in nonfracture patients following total hip arthroplasty (THA) are unclear. The aim of the present research was to study the predictors of transfusion risk in nonfracture patients following THA and develop a nomogram. One thousand six hundred and thirty-five patients who underwent THA due to nonfracture disease in our institution between September 2013 and July 2017 were included. Independent predictors of transfusion were identified by univariate, LASSO, and multivariate analyses. A nomogram was established based on independent predictors. In addition, a prospective cohort was used to validate the nomogram. The area under the receiver operating characteristic curve was utilized to evaluate the discrimination of the nomogram. Calibration and decision curve analyses were established to evaluate the nomogram. In addition, the association between perioperative transfusion and 30- and 90-day complications was studied. The incidence of transfusion was 15.78%, and 10 independent predictors were confirmed. The areas under the curve of the nomogram were 0.834 and 0.867 in the training and validation cohorts, respectively. Moreover, the area under the curve of the nomogram was significantly higher than that of any single predictor in both the training and validation cohorts. Calibration curve and decision curve analyses in both the training and validation cohorts showed good performance of the nomogram. In addition, perioperative transfusion was identified as an independent risk factor for both 30- and 90-day complications. Generally, ten transfusion-related factors for nonfracture patients following THA were identified. A validated nomogram was established, and several adverse events were confirmed to be associated with transfusion.

A nomogram to predict postoperative surgical site infection of adult patients who received orthopaedic surgery: a retrospective study

“…Moreover, our predictive model aims for all adult patients following orthopaedic surgeries. This was different from other studies that targeted patients with particular conditions, for instance, Peng et al 18 formulate a nomogram for elderly patients with hip fracture, and Wang et al 19 establish a model for nonfracture patients following total hip arthroplasty. From this point of view, our predictive model has wider clinical applicability than others.…”

Establishment and validation of a nomogram to predict postoperative anemia after total hip arthroplasty

“…Perioperative blood management is essential in preventing these complications. Gilbody et al reported the incidence of postoperative blood transfusion after THA to be between 16.9% and 50%, with about half of postoperative blood transfusions exceeding 2 units [ 3 , 10 ]. However, transfusion can lead to transfusion-related complications, increase the risk of bacterial infection and death, and may also increase economic burden [ 4 , 11 ].…”