Abstract
BackgroundAnemia is one of severe complications in the perioperative period of total hip arthroplasty (THA). Erythropoietin (EPO) has been considered to improve patients’ anemia state, but its efficiency and safety remains controversial.MethodsA total of 152 patients who underwent total hip arthroplasty from January 2017 to March 2019 were randomized to 2 groups. Recombinant human erythropoietin (rHu-EPO) group was treated with rHu-EPO subcutaneous injection 10000 IU after operation and once daily in the next week, while control group was treated with none extra treatment. Routine hematologic examination and thrombelastography (TEG) performed at different time point respectively. Doppler ultrasound for bilateral lower limbs was performed 1 day before surgery and 7 days after surgery. Auxiliary examination outcomes, blood transfusions outcomes, and postoperative complications were recorded as assessment indicators.ResultsThe difference in the relevant indexes of traditional coagulation and TEG values between two groups were not significantly. No significant difference was observed in the incidence of thromboembolism events and other complications between two groups during postoperative period. The amount of intraoperative blood loss was similar between the two groups. However, the postoperative use and dosage of allogeneic blood in the rHu-EPO group were lower than those in the control group. The hemoglobin and hematocrit level in the rHu-EPO group were higher than that in the control group after surgery.ConclusionPostoperative subcutaneous injection of rHu-EPO can improve hematological anemia-related parameters, reduce the use and dosage of allogeneic blood transfusions (ABTs), and has no significant influence on the formation of thrombosis and other complications in patients undergoing total hip arthroplasty in short term.
Highlights
Total hip arthroplasty (THA) is considered to be distinctly advantageous for various end-staged hip diseases [1, 2]
Patients undergoing total hip arthroplasty (THA) are always plagued with anemia due to blood loss [4] and perioperative anemia may lead to an increased morbidity and mortality [5]
Plenty of strategies are used in the perioperative period of THA to reduce Allogenic blood transfusions (ABT) requirements and the application of hematopoietic agents has proven effective [8,9,10]
Summary
Total hip arthroplasty (THA) is considered to be distinctly advantageous for various end-staged hip diseases [1, 2]. Patients undergoing THA are always plagued with anemia due to blood loss [4] and perioperative anemia may lead to an increased morbidity and mortality [5]. Additional allogenic blood transfusions (ABTs) are an effective method to improve anemia state but could increase risks of virus transmission, transfusion reactions, and possible immunosuppression [6, 7]. Plenty of strategies are used in the perioperative period of THA to reduce ABT requirements and the application of hematopoietic agents has proven effective [8,9,10]. Erythropoietin (EPO) is one of the erythropoiesisstimulating drugs, which promotes hematopoietic stem cells differentiate into red blood cell to improve the anemia state of patients. Studies associated with the effect of rHu-EPO on coagulation function of patients undergoing THA are still lacking. Erythropoietin (EPO) has been considered to improve patients’ anemia state, but its efficiency and safety remains controversial
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