Abstract
BackgroundExcessive 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.MethodsThis 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.ResultsThe 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).ConclusionWe 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.
Highlights
Total joint arthroplasty (TJA) can cause substantial blood loss, which increases the risk of blood transfusion during the perioperative period
*P < 0.05 was considered statistically significant aDVT deep vein thrombosis, TJA total joint arthroplasty, SD standard deviation, BMI body mass index, COPD chronic obstructive pulmonary disease, TKA total knee arthroplasty logistic regression analysis showed that transfusion was the independent risk factor for postoperative DVT (P = 0.001; OR = 3.9, 95% CI 1.8–8.4) after adjustment for gender, age, BMI, primary diagnosis, and type of surgery (Table 3)
In this study, we retrospectively studied 718 patients undergoing primary unilateral TKA or total hip arthroplasty (THA) to explore the relationship between perioperative allogenic blood transfusion and DVT within postoperative 30 days
Summary
Total joint arthroplasty (TJA) can cause substantial blood loss, which increases the risk of blood transfusion during the perioperative period. The reported transfusion rates are 11.0–19.6% in total knee arthroplasty (TKA) and. Patients receiving transfusion during TJA are at higher risk of surgical site infection, cardiopulmonary complications, prolonged length of hospitalization, increased costs, and even mortality [3, 4]. Transfusion has proven to be associated with postoperative deep vein thrombosis (DVT) in fields outside of orthopedics, including general surgery [5], urology [6], cardiac surgery [7], vascular surgery [8], obstetrics, and gynecology [9, 10]. Excessive blood loss caused by total joint arthroplasty (TJA) often increases the requirement for blood transfusion, which is associated with adverse outcomes.
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