Preoperative hematocrit on early prosthetic joint infection and deep venous thrombosis rates in primary total hip arthroplasty: A database study

Abstract

BackgroundTotal hip arthroplasty (THA) is a very successful surgery in restoring a patient’s quality of life. Infection is a devastating complication of THA. Many risks factors for infection in THA have been identified but little is known of the effect by preoperative hematocrit. PurposeWe aimed to evaluate the effect of preoperative hematocrit on early superficial site infections, deep infections, and deep organ space infections. MethodsOur study cohort included patients undergoing a THA in the ACS National Surgical Quality Improvement Program database from 2006 to 2015. We conducted a multivariate logistic regression analysis to evaluate an association between preoperative hematocrit and infection controlling for patients demographics and known risk factors. ResultsA total of 98,869 patients were identified in this study. Of these, 702 (0.71%) developed a superficial site infection, 314 (0.32%) a deep infection, and 226 (0.23%) an organ space infection. Our results suggested a significant increased risk of deep infection (OR=2.38, p=0.0120) and organ space infection (OR=3.05, p=0.0234) in patients with lower preoperative hematocrit (<41). In addition, patients with lower preoperative hematocrit had higher chance to receive postoperative transfusion (OR=2.93, p<0.0001). However, no significant associations between preoperative hematocrit and superficial site infections (p=0.8554), wound dehiscence (p=0.0660) and DVT (p=0.9236) were detected. ConclusionLow preoperative hematocrit is associated with increased risk of deep, organ space infections, and postoperative transfusion in THA, but not with superficial site infections, wound dehiscence and DVT.