Academic Journal
An observational study of an adjusted patient blood management protocol intended to lower rates of transfusion following total knee arthroplasty in patients with preoperative anemia
| العنوان: | An observational study of an adjusted patient blood management protocol intended to lower rates of transfusion following total knee arthroplasty in patients with preoperative anemia |
|---|---|
| المؤلفون: | Hervé Hourlier, Peter Fennema |
| المصدر: | Journal of Orthopaedic Surgery and Research, Vol 18, Iss 1, Pp 1-8 (2023) |
| بيانات النشر: | BMC, 2023. |
| سنة النشر: | 2023 |
| المجموعة: | LCC:Orthopedic surgery LCC:Diseases of the musculoskeletal system |
| مصطلحات موضوعية: | Patient blood management, Tranexamic acid, Total knee arthroplasty, Blood transfusion, Anemia, Epoetin alfa, Orthopedic surgery, RD701-811, Diseases of the musculoskeletal system, RC925-935 |
| الوصف: | Abstract Background Patients with preoperative anemia have a higher risk of requiring blood transfusion after major orthopedic surgery due to increased blood loss and closer transfusion thresholds. Various patient blood management (PBM) policies aim to reduce transfusion rates. This observational study aimed to investigate blood loss and evaluate the effectiveness of an adjusted surgical PBM protocol in patients with anemic chronic disease (ACD) undergoing elective total knee arthroplasty (TKA). Methods A consecutive cohort of patients underwent elective unilateral TKA with an adjusted PBM protocol. The protocol consisted of epoetin (EPO) alfa therapy prescribed by the surgeon, routine administration of tranexamic acid (TXA), and standardized postoperative pharmacologic prophylaxis for thromboembolism. The performance of this PBM protocol was analyzed in patients with a baseline hemoglobin level of less than 12 g/dl. Hemoglobin levels were controlled at admission, on postoperative day (POD) 1, and on POD 7 ± 1. A bleeding index (BI-7) was used as an estimate of blood loss up until POD 7. Multiple linear regression was used to assess whether there were any differences in BI-7 between ACD– and ACD + patients. Results A total of 751 patients with complete hemoglobin monitoring were included in the study. Of these patients, 68 (9.1%) had a baseline hemoglobin concentration of less than 12 g/dl (ACD group). In this group, 28 patients (41.2%) received preoperative EPO therapy. The mean adjusted BI-7 for the study population was 3.0 (95% CI, 2.9 to 3.0) g/dl in the ACD– group and 2.3 (95% CI, 2.0–2.6) g/dl in the ACD + group. The difference in BI-7 was statistically significant (difference, 0.6 [95% CI: 0.3 to 0.9] g/dl, p |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1749-799X |
| Relation: | https://doaj.org/toc/1749-799X |
| DOI: | 10.1186/s13018-023-04404-1 |
| URL الوصول: | https://doaj.org/article/e91a4f8505ef48dc8fec81a0101b96f6 |
| رقم الانضمام: | edsdoj.91a4f8505ef48dc8fec81a0101b96f6 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 1749799X |
|---|---|
| DOI: | 10.1186/s13018-023-04404-1 |