The effect of desmopressin on blood loss in patients with rheumatoid arthritis undergoing hip arthroplasty

Leino, Kari; Pälve, Heikki; Tiusanen, Hannu; Tuppurainen, T.

doi:10.1111/j.1399-6576.2010.02255.x

Cited by 17 publications

(37 citation statements)

References 27 publications

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“…The risk for requiring a blood transfusion was about 50% higher for RA patients in our cohort compared to OA patients; similar observations have previously been published for total hip and shoulder arthroplasty [23, 40] . The increased requirement for blood product substitution is believed to partly relate to iron deficiency anemia caused by chronic non-steroidal analgesic use, anemia of chronic disease and bone marrow depression due to medications, all of which are common in RA patients [3, 34] .…”

Section: Discussionsupporting

confidence: 89%

Rheumatoid Arthritis vs Osteoarthritis in Patients Receiving Total Knee Arthroplasty: Perioperative Outcomes

Stundner

Danninger

Chiu

et al. 2014

The Journal of Arthroplasty

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There is a paucity of data available on perioperative outcomes of patients undergoing total knee arthroplasty (TKA) for rheumatoid arthritis (RA). We determined differences in demographics and risk for perioperative adverse events between patients suffering from osteoarthritis (OA) versus RA using a population-based approach. Of 351,103 entries for patients who underwent TKA, 3.4% had a diagnosis of RA. RA patients were on average younger [RA: 64.3 years vs OA: 66.6 years; p<0.001] and more likely female [RA: 79.2% vs OA: 63.2%; P<0. 001]. The unadjusted rates of mortality and most major perioperative adverse events were similar in both groups, with the exception of infection [RA: 4.5% vs. OA: 3.8%; P<0.001]. RA was not associated with increased adjusted odds for combined adverse events.

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Section: Discussionsupporting

confidence: 89%

Rheumatoid Arthritis vs Osteoarthritis in Patients Receiving Total Knee Arthroplasty: Perioperative Outcomes

Stundner

Danninger

Chiu

et al. 2014

The Journal of Arthroplasty

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“…Anemia of chronic disease, iron deficiency anemia, and bone marrow suppression secondary to medications, which are common findings in patients with RA, are thought to play a role in this increased requirement [16,17]. Similar to the present study, Stundner et al and Elke et al found that the total length of surgical stay was significantly higher in rheumatoid patients (mean of 3.6 vs. 3.5 days, and median of 25 vs. 23 days; p<0.05) [18][19][20][21][22][23]. Although consistent with our study in terms of longer lengths of stay in the RA cohort, the study by Elke et [24].…”

Section: Discussionsupporting

confidence: 90%

Thirty-day complications in rheumatoid patients following total knee arthroplasty

et al. 2015

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Although total knee arthroplasty (TKA) is highly successful for patients with end-stage rheumatoid arthritis (RA), the risks and complications associated with surgery in this cohort are less defined. The objectives of our study were to analyze the demographic and perioperative factors of RA patients that may affect post-TKA outcomes, as well as to assess the 30-day complication rates compared to osteoarthritis patients. We retrospectively evaluated the National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2012 to assess all patients who underwent a primary TKA and had a diagnosis of rheumatoid arthritis (n = 141) or primary knee osteoarthritis (n = 7125). We evaluated and compared the demographic factors, social factors, preoperative factors, operative factors, and postoperative complications. The RA cohort had a lower mean age and body mass index than patients in the OA group. There was also a significantly higher incidence of women and Hispanics in the RA cohort. There was a lower incidence of diabetes and hypertension requiring medication in the rheumatoid cohort, but also a higher incidence of bleeding disorders. The RA cohort had an increased proportion of patients requiring blood transfusions and had a longer mean length of stay. The incidence of pneumonia and postoperative bleeding that required transfusion was also higher in RA patients. Rheumatoid patients had higher rates of wound infections, pulmonary embolisms, and deep vein thrombosis; however, these findings were not significant. Although RA patients with end-stage knee arthritis may benefit from TKA, these patients should be preoperatively optimized to minimize complication risks.

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“…Blood transfusion was not with zero risk, it has the potential of the transmission of viral diseases and increase cardiac load 4 – 7 . Many methods (controlled hypotension, hypotensive anaesthesia and administration with desmopressin) have been used to reduce blood loss 8 – 10 . These methods have drawbacks such as the increase in economic cost and the increase in the chance of thrombosis.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review and Meta-analysis of the Topical Administration of Fibrin Sealant in Total Hip Arthroplasty

Zhao

Sun

et al. 2018

Sci Rep

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Patients who undergo total hip arthroplasty (THA) may experience a large amount of blood loss. The objective of our study is to include randomized controlled trials (RCTs) and compare the clinical outcomes of fibrin sealant (FS) versus placebo after a THA. In October 2015, we searched the following databases: Medline, Embase, PubMed, the Cochrane Controlled Trials Register, Web of Science, the China National Knowledge Infrastructure, the China Wanfang database and Google Scholar. Finally, seven studies that included 679 patients met the inclusion criteria. The meta-analysis indicated that the topical administration of FS was associated with a reduction of the need for transfusion compared to the control group (P = 0.05). And topical FS will reduce total blood loss after THA (P = 0.0003) and blood loss in drainage (P = 0.002). However, there was no significant difference in terms of the intraoperative blood loss (P = 0.62) and the rate of deep venous thrombosis (DVT), fever, pain, anemia, hematoma and oozing. In conclusion, the use of FS in patients who are undergoing THA may reduce perioperative blood loss and attenuate the decrease in Hb. Furthermore, FS do not decrease the intraoperative blood loss without an increase in the risk of postoperative DVT, fever, pain, anemia, hematoma and oozing.

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The effect of desmopressin on blood loss in patients with rheumatoid arthritis undergoing hip arthroplasty

Cited by 17 publications

References 27 publications

Rheumatoid Arthritis vs Osteoarthritis in Patients Receiving Total Knee Arthroplasty: Perioperative Outcomes

Rheumatoid Arthritis vs Osteoarthritis in Patients Receiving Total Knee Arthroplasty: Perioperative Outcomes

Thirty-day complications in rheumatoid patients following total knee arthroplasty

A Systematic Review and Meta-analysis of the Topical Administration of Fibrin Sealant in Total Hip Arthroplasty

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