Abstract
Background Total joint arthroplasty (TJA) usually leads to substantial blood loss, which may cause allogenic blood transfusion. Hypothermia occurring during operation has been reported to increase blood loss and transfusion rates in nonorthopedic cohorts. However, the relationship between intraoperative hypothermia and blood loss remains controversial in patients undergoing orthopedic surgeries. The aims of this study were to investigate the incidence of hypothermia and identify the impact of intraoperative body temperature and hypothermia on blood loss and transfusion rates in total knee and hip arthroplasty (TKA and THA, respectively). Methods This retrospective study enrolled 616 consecutive patients, who underwent primary unilateral TKA or THA at our institution during the period from April 2012 to July 2014. The occurrence of a temperature below 36°C during the operation was documented to identify the incidence of hypothermia. Univariate analysis was performed to find the risk factors for hypothermia. Multiple regression analysis and multivariate logistic regression analysis were employed to explore the association of intraoperative temperature and hypothermia with intraoperative blood loss and perioperative blood transfusion. Results The incidence of intraoperative hypothermia was 13.5%, 14.0%, and 13.1% in TJA, TKA, and THA, respectively. Intraoperative temperature (P = 0.045, P = 0.006) and hypothermia (P = 0.042, P < 0.001) were associated with intraoperative blood loss and perioperative transfusion in TKA. Intraoperative temperature (P = 0.002) was negatively related to the amount of blood loss, and hypothermia (P = 0.031) was the independent risk factor for transfusion in THA. Conclusion Intraoperative hypothermia is associated with increased blood loss and transfusion rates in TJA. Efforts should be made to maintain normothermia during operation in these patients.
Highlights
Total joint arthroplasty (TJA) can cause substantial blood loss, which may lead to the requirement of allogeneic blood transfusion
Intraoperative hypothermia has proven to be associated with higher rates of blood transfusion in nonorthopedic cohorts [3]
The relationship between intraoperative hypothermia and blood loss remains controversial in patients undergoing orthopedic surgeries [4]
Summary
Total joint arthroplasty (TJA) can cause substantial blood loss, which may lead to the requirement of allogeneic blood transfusion. Intraoperative hypothermia has proven to be associated with higher rates of blood transfusion in nonorthopedic cohorts [3]. Maintaining body temperature during spinal surgeries under general anesthesia reduces blood loss and transfusion rate. The aims of this study were to investigate the incidence of hypothermia and identify the impact of intraoperative body temperature and hypothermia on blood loss and transfusion rates in total knee and hip arthroplasty (TKA and THA, respectively). Intraoperative temperature (P = 0:002) was negatively related to the amount of blood loss, and hypothermia (P = 0:031) was the independent risk factor for transfusion in THA. Intraoperative hypothermia is associated with increased blood loss and transfusion rates in TJA. Efforts should be made to maintain normothermia during operation in these patients
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