Analysis Of Related Factors Of Allogeneic Blood Transfusion After Primary Total Hip Arthroplasty

ObjectiveTo study the rate of allogeneic blood transfusion after total hip replacement,compare the perioperative data of patients in transfusion group and non-transfusion group,and analyze the related risk factors,in order to provide theoretical basis for reducing allogeneic blood transfusion after total hip arthroplasty.MethodsA total of 516 patients who underwent primary total hip arthroplasty from June 2015 to December 2018 in the orthopedic ward of the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively by electronic medical record system.Patients were divided into allogeneic transfusion group(N=102)and non-transfusion Group(N=414)according to whether they received allogeneic blood transfusion after operation,collate the related indexes that may affect the rate of allogeneic transfusion after operation,including the general data of sex,age,body mass index(BMI),preoperative diagnosis,etc.The American Society of anesthesiologists(ASA)score,preoperative complications,preoperative hypertension classification,preoperative platelet and hemoglobin values;The time of operation,the amount of bleeding,whether to place drainage tube or not,and the concentration of calcium ion were recorded after operation.According to the different data types,we used independent sample t test,Mann-Whitney U test or chi-square test to screen out the different perioperative indexes Finally,Binary Logistic regression analysis was used to determine the risk factors associated with blood transfusion.The experiment was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University in July 2019.Results1.Of the 516 patients who underwent total hip replacement,102 patients underwent allogeneic transfusion due to anemia.The allogeneic transfusion rate was 19.8%.2.The results of single factor analysis showed that,there were significant differences in sex,age,preoperative diagnosis,hypertension grade,preoperative hemoglobin concentration,intraoperative unilateral and bilateral operation,drainage tube placement or not,and postoperative calcium concentration between allogeneic transfusion group and non-transfusion group(P<0.05).3.Binary Logistic regression analysis showed that gender(OR=0.557,P=0.034),preoperative diagnosis of primary or secondary osteoarthritis and rheumatoid arthritis(OR=4.868,P=0.001),hypertension above grade 2(OR=8.053,P<0.01),preoperative hemoglobin concentration(OR=0.949,P=0.001),one-stage bilateral operation(OR=7.322,P<0.01),intraoperative drainage tube placement(OR=1.911,P=0.016)and postoperative calcium concentration(OR=0.198,P=0.003)are the risk factors of allotransfusion.ConclusionThe allogeneic transfusion rate was 19.8%after total hip arthroplasty in this study,gender,osteoarthritis,Rheumatoid Arthritis,hypertension above grade 2,preoperative anemia,one-stage bilateral hip replacement,drainage tube placement and postoperative hypocalcemia were risk factors for allogeneic blood transfusion after total hip replacement.Therefore,perioperative blood management measures should be taken to reduce the rate of allogeneic blood transfusion in patients with these risk factors.