Perioperative allogenic blood transfusion increases the incidence of postoperative deep vein thrombosis in total knee and hip arthroplasty

Abstract

Background Excessive blood loss caused by total joint arthroplasty (TJA) often increases the requirement for blood transfusion, which is associated with adverse outcomes. The purpose of this study was to determine the relationship between perioperative transfusion and postoperative DVT in TJA. Methods This retrospective study reviewed medical records of 715 patients, who consecutively underwent primary unilateral total knee arthroplasty (TKA) or total hip arthroplasty (THA) at our institution between September 2015 and March 2017. Demographic, clinical and surgical parameters were introduced into the univariate analysis to find risk factors for DVT within postoperative 30 days. In order to identify if allogenic blood transfusion was independently associated with DVT, a multivariate logistic regression analysis was conducted to adjust for gender, age, body mass index (BMI), diagnosis, and type of surgery. Results The incidence of perioperative allogenic blood transfusion was 12.4% ( n = 89). Fifty-seven patients (8.0%) developed DVT after surgery. Univariate analysis demonstrated that there were differences between DVT group and non-DVT group in gender ( P = 0.045), age ( P < 0.001), BMI ( P = 0.026), primary diagnosis ( P = 0.001), type of surgery ( P < 0.001), and transfusion rates ( P = 0.040). After adjustment by using multivariate logistic regression analysis, transfusion appeared to be the independent risk factor for DVT in TJA ( P = 0.001; OR = 3.9, 95%CI 1.8–8.4). Conclusion We found that perioperative allogenic blood transfusion was significantly associated with DVT following TJA. In order to reduce the risk of DVT and other adverse outcomes, methods to decrease transfusion rates should be used in clinical practice.

Risk factors for deep vein thrombosis even using low-molecular-weight heparin after total knee arthroplasty

“…Rodgers et al reported that epidural anesthesia reduced DVT incidence compared to general anesthesia [ 31 ]. Jiang et al also reported that perioperative allogenic blood transfusion was significantly related to DVT following total joint arthroplasty [ 32 ]. However, there is a paucity of literature regarding DVT after TKA with the use of anticoagulation chemoprophylaxis in the Asian population.…”

Perioperative red blood cell infusion and deep vein thrombosis in patients with femoral and pelvic fractures: a propensity score matching

“…Jackson, Hart, Frisch et al reported that perioperative RBC infusion does not significantly increase the incidence of venous thromboembolism (VTE) after total joint replacement [ 14 – 16 ]. Rothstein, Helm, Jiang, Goel, Dillon et al proved that perioperative RBC infusion would increase the risk of VTE in patients undergoing surgery [ 8 – 13 ], such as pediatric surgery [ 8 ], ventral hernia repair [ 9 ], total knee and hip arthroplasty [ 10 ]. It is necessary to conduct PSM analysis of perioperative RBC infusion and DVT.…”

Perioperative red blood cell infusion and deep vein thrombosis in patients with femoral and pelvic fractures: A propensity score matching

“…Bone trauma patients are at high risk of DVT.A large number of literatures have reported the risk factors related to DVT in patients with perioperative bone trauma, such as lower extremity and pelvic fracture, high energy trauma, Glasgow score, prolonged preoperative waiting time, long operative time, advanced age, obesity, and history of malignant tumor [11][12][13] . The relationship between perioperative RBC infusion and the risk of DVT is controversial.Jackson, Hart, Frisch et al reported that perioperative erythrocyte infusion does not signi cantly increase the incidence of venous thromboembolism (VTE) after total joint replacement [14][15][16] .Rothstein,Helm,Jiang, Goel, Dillon et al proved that perioperative RBC infusion would increase the risk of VTE [3,6,8,[17][18][19] . In recent years, studies on the correlation between the two have drawn contradictory conclusions.…”

“…However, the correlation between perioperative RBC infusion and DVT has not yet been concluded, and even contradictory conclusions have appeared. It is reported that the RBC infusion rate of patients undergoing total knee arthroplasty is 10-20% [8,9] . Patients with severe bone trauma suffer from traumatic blood loss before surgery, and face the risk of bleeding during and after surgery, and the perioperative RBC infusion rate is not low.…”