The Impact Of Intraoperative Hypothermia On Blood Loss And Allogenic Blood Transfusion In Total Knee And Hip Arthroplasty

Background:Total joint arthroplasty(TJA)usually leads to substantial blood loss,which may cause allogenic blood transfusion Hypothermia is a common clinical complication.It is reported that hypothermia can increase blood loss and blood transfusion rate in non orthopedic population.In addition,some studies have confirmed that hypothermia will lead to increased infection,prolonged hospital stay,increased treatment costs,and hypothermia will seriously affect the coagulation function of patients,which has a certain correlation with more intraoperative blood loss,but the previous reports rarely involve the clinical research of intraoperative temperature and intraoperative blood loss and transfusion in joint replacement.We consider that this may be One of the possible factors with more intraoperative bleeding.Thus,the aims of this study were to investigate the incidence and risk factors of hypothermia and identify the impact of intraoperative body temperature and hypothermia on blood loss and transfusion rates in total knee and hip arthroplasty(TKA and THA)Methods:This retrospective study enrolled 616 consecutive patients,who underwent primary unilateral TKA or THA at our institution during the period from April 2012 to July 2014.Patient demographic and clinical data was collected from medical records,including age,gender,body mass index(BMI),preexisting illnesses(diabetes,hypertension,and malignancy),primary diagnosis,and operation time.The data of preoperative laboratory examinations,such as hemoglobin(Hb)concentration,blood platelet count(PL T),plasma prothrombin time(PT),international normalized ratio(INR),and activated partial thromboplastin time(APTT),was also documented.The occurrence of temperature below 36?during operation was documented to identify the incidence of hypothermia.Univariate analysis was performed to find the risk factors for hypothermia.Multiple regression analysis and multivariate logistic regression analysis were employed to explore the association of body temperature and hypothermia with intraoperative blood loss and perioperative blood transfusionResults:The incidence of intraoperative hypothermia was 13.5%,14.0%and 13.1%in TJA,TKA and THA,respectively.Lower body temperature(P=0.045;P=0.006)and hypothermia(P=0.042;P<0.001)were associated with increased intraoperative blood loss and perioperative transfusion in TKA.Body temperature(P=0.002)was negatively related to the amount of blood loss,and hypothermia(P=0.031)was the independent risk factor for transfusion in THAConclusion:There is a significant correlation between hypothermia and the increase of blood loss and blood transfusion rate.There is no significant difference in the occurrence of hypothermia in hip and knee arthroplasty During the operation,the bleeding and temperature of patients should be monitored at all times,and the normal temperature of patients should be kept as far as possible.