What are the complication rates and risk factors for patients after primary total hip and knee arthroplasty?
A group of researchers examined the National Surgical Quality Improvement Program data to find out and published their results in the Journal of Bone & Joint Surgery. The researchers included 9,362 total hip and 13,662 total knee replacement patients and separated those with red blood cell transfusions performed within 72 hours after surgery from those with no transfusion.
Here are five findings from the study:
1. After total hip replacement, the transfusion rate was 22.2 percent. After total knee replacement, the transfusion rate was 18.2 percent.
2. The significant risk factors for receiving blood transfusion after both total knee and total hip replacement were:
• Age
• Preoperative anemia
• Female sex
• Body mass index greater than 30 kg/m2
• American Society of Anesthesiologists class score greater than two
3. The multivariate logistic regression analysis showed no difference between the two groups of patients for adjusted odds of injection, venous thormboembolism and mortality for total hip replacement patients.
4. For total knee replacement patients, transfusion rates were significantly associated with mortality but not with infection or venous thromboembolism.
5. Although the study authors did not find a strong association between perioperative red blood cell transfusion and 30-day incidences of infection, VTE or mortality, they did conclude, "The odds of mortality were higher in patients who received a transfusion during total knee arthroplasty."