Predicting Perioperative Transfusion in Elective Hip and Knee Arthroplasty: A Validated Predictive Model

Josephine To, Romi Sinha, Susan W Kim, Kathryn Robinson, Brendon Kearney, Donald Howie, Luen Bik To

Research output: Contribution to journalArticle

6 Citations (Scopus)

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.

LanguageEnglish
Pages317-325
Number of pages9
JournalAnesthesiology
Volume127
Issue number2
DOIs
Publication statusPublished - 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

To, J., Sinha, R., Kim, S. W., Robinson, K., Kearney, B., Howie, D., & To, L. B. (2017). Predicting Perioperative Transfusion in Elective Hip and Knee Arthroplasty: A Validated Predictive Model. Anesthesiology, 127(2), 317-325. https://doi.org/10.1097/ALN.0000000000001709
To, Josephine ; Sinha, Romi ; Kim, Susan W ; Robinson, Kathryn ; Kearney, Brendon ; Howie, Donald ; To, Luen Bik. / Predicting Perioperative Transfusion in Elective Hip and Knee Arthroplasty : A Validated Predictive Model. In: Anesthesiology. 2017 ; Vol. 127, No. 2. pp. 317-325.
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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.",
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To, J, Sinha, R, Kim, SW, Robinson, K, Kearney, B, Howie, D & To, LB 2017, 'Predicting Perioperative Transfusion in Elective Hip and Knee Arthroplasty: A Validated Predictive Model', Anesthesiology, vol. 127, no. 2, pp. 317-325. https://doi.org/10.1097/ALN.0000000000001709

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 journalArticle

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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.

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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

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SP - 317

EP - 325

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 2

ER -