Study finds, Independent Risk Factors for Transfusion in Con
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The incidence of transfusion in contemporary revision total hip arthroplasty (THA) remains high despite recent advances in blood management, including the use of tranexamic acid (TXA). The purpose of this prospective investigation was to determine independent risk factors for transfusion in revision THA.

6 centers prospectively collected data on 175 revision THAs. A multivariable logistic analysis was performed to determine independent risk factors for transfusion. Revisions were categorized into subgroups for analysis including:
-Femur only,
-Acetabulum only,
-Both-component, explant/spacer, and
-Second stage reimplantation.
Patients undergoing an isolated modular exchange were excluded.

Results:
--29 Patients required at least one unit of blood (16.6%).

--In the logistic model, significant risk factors for transfusion were lower preoperative hemoglobin, higher preoperative international normalized ratio (INR) and longer operative time.

--For each preoperative 1g/dL decrease in hemoglobin, the chance of transfusion increased by 79%.

--For each 0.1 unit increase in preoperative INR, transfusion chance increased by 158%. For each additional operative hour, the chance of transfusion increased by 74%.

--There were no differences in transfusion rates between categories of revision hip surgery. No differences in demographic or surgical variables were found between revision types.

Transfusions are frequently needed in revision THA despite the use of TXA. Where medically practicable, preoperative hemoglobin and INR optimization are suggested. Where theoretically practicable, attempts should also be made to minimize operative time.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0883540321002825?dgcid=rss_sd_all
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