Background: The aim of this study was to identify clinical factors
associated with an increased need for perioperative blood transfusion in
nonanemic patients undergoing total hip arthroplasty.
Methods: We evaluated eighty-five consecutive nonanemic patients who
underwent elective, unilateral, cementless, primary total hip arthroplasty and
met our inclusion criteria. We attempted to determine whether clinical
parameters influencing perioperative blood loss, such as age, gender,
hypertension, and body mass index, were also associated with the need for
perioperative blood transfusion.
Results: Perioperative blood transfusion was required in twenty-four
(28%) of the eighty-five nonanemic patients. When considered alone, age,
gender, hypertension, and body mass index were not significantly associated
with an increased risk of perioperative blood transfusion, on the basis of the
numbers available. In contrast, there was a significantly increased risk of
blood transfusion when two or more of these clinical parameters were present
(p = 0.02).
Conclusions: Our findings indicate that clinical variables such as
age, gender, hypertension, and body mass index may have a synergistic effect
on the risk of transfusion in patients undergoing elective total hip
arthroplasty. The simultaneous analysis of these parameters might help to
stratify patients with different risks for transfusion and may increase the
efficiency and reduce the cost of blood-ordering practices associated with
total hip arthroplasty.
Level of Evidence: Prognostic study, Level II-1
(retrospective study). See Instructions to Authors for a complete description
of levels of evidence.