Perioperative allogenic blood transfusion increases the incidence of postoperative deep vein thrombosis in total knee and hip arthroplasty

• Published in: Journal of orthopaedic surgery and research Vol. 14; no. 1; p. 235
• Main Authors: Jiang, Tao, Song, Kai, Yao, Yao, Pan, Pin, Jiang, Qing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23.07.2019; BioMed Central; BMC
• Subjects: Adult; Aged; Aged, 80 and over; Allogenic blood transfusion; Arthroplasty; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - trends; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - trends; Blood transfusion; Blood Transfusion - trends; Complications and side effects; Deep vein thrombosis; Female; Hip replacement arthroplasty; Humans; Incidence; Knee replacement arthroplasty; Male; Medical records; Medical research; Middle Aged; Orthopedic surgery; Perioperative Care - adverse effects; Perioperative Care - trends; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Regression analysis; Retrospective Studies; Risk factors; Rivaroxaban; Surgery; Total hip arthroplasty; Total knee arthroplasty; Tranexamic acid; Venous thrombosis; Venous Thrombosis - diagnosis; Venous Thrombosis - epidemiology; Young Adult; China; Deep vein thrombosis; Allogenic blood transfusion; Total knee arthroplasty; Total hip arthroplasty
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-019-1270-2

Excessive blood loss caused by total joint arthroplasty (TJA) often increases the requirement for blood transfusion, which is associated with adverse outcomes. The purpose of this study was to determine the relationship between perioperative transfusion and postoperative DVT in TJA. This retrospective study reviewed medical records of 715 patients, who consecutively underwent primary unilateral total knee arthroplasty (TKA) or total hip arthroplasty (THA) at our institution between September 2015 and March 2017. Demographic, clinical and surgical parameters were introduced into the univariate analysis to find risk factors for DVT within postoperative 30 days. In order to identify if allogenic blood transfusion was independently associated with DVT, a multivariate logistic regression analysis was conducted to adjust for gender, age, body mass index (BMI), diagnosis, and type of surgery. The incidence of perioperative allogenic blood transfusion was 12.4% (n = 89). Fifty-seven patients (8.0%) developed DVT after surgery. Univariate analysis demonstrated that there were differences between DVT group and non-DVT group in gender (P = 0.045), age (P < 0.001), BMI (P = 0.026), primary diagnosis (P = 0.001), type of surgery (P < 0.001), and transfusion rates (P = 0.040). After adjustment by using multivariate logistic regression analysis, transfusion appeared to be the independent risk factor for DVT in TJA (P = 0.001; OR = 3.9, 95%CI 1.8-8.4). We found that perioperative allogenic blood transfusion was significantly associated with DVT following TJA. In order to reduce the risk of DVT and other adverse outcomes, methods to decrease transfusion rates should be used in clinical practice.