Abstract
BACKGROUND: Preoperative anemia is a significant predictor of perioperative erythrocyte transfusion in elective arthroplasty patients. However, interactions with other patient and procedure characteristics predicting transfusion requirements have not been well studied.
METHODS: Patients undergoing elective primary total hip arthroplasty or total knee arthroplasty at a tertiary hospital in Adelaide, South Australia, Australia, from January 2010 to June 2014 were used to identify preoperative predictors of perioperative transfusion. A logistic regression model was developed and externally validated with an independent data set from three other hospitals in Adelaide.
RESULTS: Altogether, 737 adult patients in the derivation group and 653 patients in the validation group were included. Binary logistic regression modeling identified preoperative hemoglobin (odds ratio, 0.51; 95% CI, 0.43 to 0.59; P < 0.001 for each 1 g/dl increase), total hip arthroplasty (odds ratio, 3.56; 95% CI, 2.39 to 5.30; P < 0.001), and females 65 yr of age and older (odds ratio, 3.37; 95% CI, 1.88 to 6.04; P = 0.01) as predictors of transfusion in the derivation cohort.
CONCLUSIONS: Using a combination of patient-specific preoperative variables, this validated model can predict transfusion in patients undergoing elective hip and knee arthroplasty. The model may also help to identify patients whose need for transfusion may be decreased through preoperative hemoglobin optimization.
| Language | English |
|---|---|
| Pages | 317-325 |
| Number of pages | 9 |
| Journal | Anesthesiology |
| Volume | 127 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Aug 2017 |
Keywords
- Aged
- Arthroplasty, Replacement, Hip
- Arthroplasty, Replacement, Knee
- Blood Loss, Surgical
- Elective Surgical Procedures
- Erythrocyte Transfusion
- Female
- Humans
- Male
- Odds Ratio
- Perioperative Care
- South Australia
- Journal Article
- Multicenter Study
- Validation Studies
ASJC Scopus subject areas
- Medicine(all)
Cite this
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Predicting Perioperative Transfusion in Elective Hip and Knee Arthroplasty : A Validated Predictive Model. / To, Josephine; Sinha, Romi; Kim, Susan W; Robinson, Kathryn; Kearney, Brendon; Howie, Donald; To, Luen Bik.
In: Anesthesiology, Vol. 127, No. 2, 08.2017, p. 317-325.Research output: Contribution to journal › Article
TY - JOUR
T1 - Predicting Perioperative Transfusion in Elective Hip and Knee Arthroplasty
T2 - Anesthesiology
AU - To, Josephine
AU - Sinha, Romi
AU - Kim, Susan W
AU - Robinson, Kathryn
AU - Kearney, Brendon
AU - Howie, Donald
AU - To, Luen Bik
PY - 2017/8
Y1 - 2017/8
N2 - BACKGROUND: Preoperative anemia is a significant predictor of perioperative erythrocyte transfusion in elective arthroplasty patients. However, interactions with other patient and procedure characteristics predicting transfusion requirements have not been well studied.METHODS: Patients undergoing elective primary total hip arthroplasty or total knee arthroplasty at a tertiary hospital in Adelaide, South Australia, Australia, from January 2010 to June 2014 were used to identify preoperative predictors of perioperative transfusion. A logistic regression model was developed and externally validated with an independent data set from three other hospitals in Adelaide.RESULTS: Altogether, 737 adult patients in the derivation group and 653 patients in the validation group were included. Binary logistic regression modeling identified preoperative hemoglobin (odds ratio, 0.51; 95% CI, 0.43 to 0.59; P < 0.001 for each 1 g/dl increase), total hip arthroplasty (odds ratio, 3.56; 95% CI, 2.39 to 5.30; P < 0.001), and females 65 yr of age and older (odds ratio, 3.37; 95% CI, 1.88 to 6.04; P = 0.01) as predictors of transfusion in the derivation cohort.CONCLUSIONS: Using a combination of patient-specific preoperative variables, this validated model can predict transfusion in patients undergoing elective hip and knee arthroplasty. The model may also help to identify patients whose need for transfusion may be decreased through preoperative hemoglobin optimization.
AB - BACKGROUND: Preoperative anemia is a significant predictor of perioperative erythrocyte transfusion in elective arthroplasty patients. However, interactions with other patient and procedure characteristics predicting transfusion requirements have not been well studied.METHODS: Patients undergoing elective primary total hip arthroplasty or total knee arthroplasty at a tertiary hospital in Adelaide, South Australia, Australia, from January 2010 to June 2014 were used to identify preoperative predictors of perioperative transfusion. A logistic regression model was developed and externally validated with an independent data set from three other hospitals in Adelaide.RESULTS: Altogether, 737 adult patients in the derivation group and 653 patients in the validation group were included. Binary logistic regression modeling identified preoperative hemoglobin (odds ratio, 0.51; 95% CI, 0.43 to 0.59; P < 0.001 for each 1 g/dl increase), total hip arthroplasty (odds ratio, 3.56; 95% CI, 2.39 to 5.30; P < 0.001), and females 65 yr of age and older (odds ratio, 3.37; 95% CI, 1.88 to 6.04; P = 0.01) as predictors of transfusion in the derivation cohort.CONCLUSIONS: Using a combination of patient-specific preoperative variables, this validated model can predict transfusion in patients undergoing elective hip and knee arthroplasty. The model may also help to identify patients whose need for transfusion may be decreased through preoperative hemoglobin optimization.
KW - Aged
KW - Arthroplasty, Replacement, Hip
KW - Arthroplasty, Replacement, Knee
KW - Blood Loss, Surgical
KW - Elective Surgical Procedures
KW - Erythrocyte Transfusion
KW - Female
KW - Humans
KW - Male
KW - Odds Ratio
KW - Perioperative Care
KW - South Australia
KW - Journal Article
KW - Multicenter Study
KW - Validation Studies
U2 - 10.1097/ALN.0000000000001709
DO - 10.1097/ALN.0000000000001709
M3 - Article
VL - 127
SP - 317
EP - 325
JO - Anesthesiology
JF - Anesthesiology
SN - 0003-3022
IS - 2
ER -