Predicting transfusion in shoulder arthroplasty

Schumer, Ross A; Chae, Jonathan; Markert, Ronald J.; Sprott, D.; Crosby, Lynn A.

doi:10.1016/j.jse.2009.05.001

Cited by 37 publications

(37 citation statements)

References 23 publications

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“…A prospective study of geriatric patients with primary hip or knee arthroplasty revealed coronary artery disease as a predictor of transfusion. The association between transfusion after shoulder arthroplasty and the number of comorbidities has been inconsistent [10,12,29].…”

Section: Discussionmentioning

confidence: 99%

“…In orthopaedic surgery, comorbidities have been identified as predictors of mortality after arthroplasty, trauma surgery, and oncologic surgery [4,9,18,20,21,25,27,36]. Complications after ankle fractures, spinal metastasis surgery, and knee or hip arthroplasty also are associated with comorbidities [2,12,[31][32][33][34] as are infections after orthopaedic trauma, spine surgery, knee or hip arthroplasty [8,17,22,36], and transfusion after knee or shoulder arthroplasty [12,29].…”

Section: Introductionmentioning

confidence: 99%

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Higher Charlson Comorbidity Index Scores are Associated With Readmission After Orthopaedic Surgery

Voskuijl

Hageman

Ring

2014

Clinical Orthopaedics &Amp; Related Research

173

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Background The Charlson Comorbidity Index (CCI) originally was developed to predict mortality within 1 year of hospital admission in patients without trauma. As it includes factors associated with medical and surgical complexities, it also may be useful as a predictive tool for hospital readmission after orthopaedic surgery, but to our knowledge, this has not been studied. Questions/purposes We asked whether an increased score on the CCI was associated with (1) readmission, (2) an increased risk of surgical site infection or other adverse events, (3) transfusion risk, or (4) mortality after orthopaedic surgery. Methods A total of 30,129 orthopaedic surgeries performed between 2008 and 2011 without any orthopaedic surgery in the preceding 30 days were analyzed. International Classification of Diseases, 9 th Revision codes were used to identify diagnoses, procedures, surgery-related adverse events, surgical site infection, and comorbidities as listed in the updated and reweighted CCI. A total of 913 patients (3.0%) were readmitted within 30 days after discharge; in 393 (1.4%) patients adverse events occurred; 417 patients (1.4%) had a surgical site infection develop; 211 (0.7%) needed transfusions, and 56 (0.2%) died within 30 days after surgery. Ordinary least squares regression analyses were used to determine whether the CCI was associated with these outcomes. Results The CCI accounted for 10% of the variation in readmissions. Every point increase in CCI score added an additional 0.45% risk in readmission for patients undergoing arthroplasty, 0.63% for patients undergoing trauma surgery, and 0.9% risk for patients undergoing spine surgery (all p \ 0.01). The CCI was not associated with surgical site infection or other adverse events, but accounted for 8% of the variation in transfusion rate and 10% of the variation in mortality within 30 days of surgery. Conclusions The CCI can be used to estimate the risk of readmission after arthroplasty, hand and upper extremity surgery, spine surgery, and trauma surgery. It also can be used to estimate the risk of transfusion after arthroplasty, spine, trauma, and oncologic orthopaedic surgery and the risk of mortality after shoulder, trauma, and oncologic orthopaedic surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Higher Charlson Comorbidity Index Scores are Associated With Readmission After Orthopaedic Surgery

Voskuijl

Hageman

Ring

2014

Clinical Orthopaedics &Amp; Related Research

173

View full text Add to dashboard Cite

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“…A number of studies have looked at the incidence of and risk factors for transfusion associated with shoulder arthroplasty, although all of these studies have been based on patients receiving conventional (stemmed) shoulder replacements [6][7][8][9]. To our knowledge, this is the first study to examine the incidence of transfusion associated with surface replacement of the shoulder.…”

Section: Discussionmentioning

confidence: 99%

“…Studies examining transfusion needs associated with primary shoulder arthroplasties have reported incidences ranging between 8% to 38% ( Table 5) [6][7][8][9]. These studies have also identified some of the risk factors predictive of transfusion, including female sex [6,9], advancing age [6][7][8] and diagnoses such as trauma or rheumatoid arthritis [9]. Because only one patient in our entire study group was transfused, we considered it inappropriate to use the need for transfusion as the dependent variable.…”

Section: Discussionmentioning

confidence: 99%

Blood Loss and the Need for Transfusion after Shoulder Surface Replacement

Singh¹,

Trehan²,

Banerjee³

et al. 2013

Shoulder & Elbow

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Background Studies on stemmed primary shoulder arthroplasty have shown transfusion rates of up to 38%. The present study aimed to evaluate blood loss and the need for blood transfusion after primary humeral and total shoulder surface replacement. Materials and methods Patients undergoing both primary humeral head (n = 20) and total shoulder (n = 63) resurfacing were included. The mean drop in haemoglobin levels on the first postoperative day and the need for transfusion were recorded and analyzed against the patient's age, sex, body mass index, American Society of Anesthesiologists grade, type of surgery performed, pre-operative haemoglobin and the use of tranexamic acid. Results Only one patient in the entire series (1.2%) required blood transfusion postoperatively, following total shoulder resurfacing. There were statistically significant differences between the two groups with respect to estimated blood loss (p = 0.005), duration of surgery (p < 0.0005) and haemoglobin drop (p < 0.0005), all in favour of the humeral head resurfacing group. The type of surgery was the only independent factor significantly affecting the reduction of haemoglobin levels postoperatively (p < 0.0005). Conclusions Surface replacement of the shoulder appears to be associated with reduced blood loss, leading to a very low need for blood transfusion.

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“…Previous studies on intraoperative blood transfusion [8][9][10][11][12] have focused primarily on variables related to patients' physiological characteristics (e.g., weight, age, and sex) [13] and medication history (e.g., whether the patient is receiving nonsteroidal anti-inflammatory drugs or blood thinners) [10], the type and duration of the surgical procedure [14,15], the use of tranexamic acid [16,17], and whether patients have a history of cardiopulmonary disease [18]. A review of the literature revealed that most studies on related topics have investigated patients in the United States and Europe, but no study has addressed patients in Asian countries.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Preoperative Blood Preparation for Orthopedic Surgery Patients: A Supervised Learning Approach

Chang

Hung

et al. 2018

Applied Sciences

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Blood transfusion is a common and often necessary medical procedure during surgery. However, most physicians rely on their personal clinical experience to determine whether a patient requires a transfusion. This generally involves considering the risk of blood loss during surgery, and the preparation of blood is thus regularly requested before surgery. However, unused blood is a particularly severe problem, especially in orthopedic procedures, which not only increases medical resource wastage but also places a burden on medical personnel. This study collected the records of 1396 patients who received an orthopedic surgery in a regional teaching hospital. Data mining techniques, namely support vector machine, C4.5 decision tree, classification and regression tree, and logistic regression (LGR) were employed to predict whether patients undergoing an orthopedic surgery required an intraoperative blood transfusion. The LGR classifier, which was constructed using the CfsSubsetEval module and GeneticSearch method, exhibited optimal prediction accuracy (area under the curve: 78.7%). This study investigated major variables involved in blood transfusions to provide a clear reference for evaluating the necessity of preparing blood for surgical procedures. Data mining techniques can be used to simplify unnecessary blood preparation procedures, thereby reducing the workload of medical staff and minimizing the wastage of medical resources.

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Predicting transfusion in shoulder arthroplasty

Cited by 37 publications

References 23 publications

Higher Charlson Comorbidity Index Scores are Associated With Readmission After Orthopaedic Surgery

Higher Charlson Comorbidity Index Scores are Associated With Readmission After Orthopaedic Surgery

Blood Loss and the Need for Transfusion after Shoulder Surface Replacement

Prediction of Preoperative Blood Preparation for Orthopedic Surgery Patients: A Supervised Learning Approach

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