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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Prevalence of anaemia before major joint arthroplasty and the potential impact of preoperative investigation and correction on perioperative blood transfusions
British Journal of Anaesthesia, Volume 99, No. 6, Year 2007
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Description
Background. Preoperative investigation and treatment of anaemia is recommended before orthopaedic surgery. We measured the prevalence of anaemia among admissions presenting for elective major joint arthroplasty (MJA), assessed their transfusion requirements, and investigated factors associated with perioperative blood transfusion. Methods. All admissions to a dedicated elective orthopaedic hospital during 2000-2001 were studied. The patients' database was merged with the haematology and transfusion databases. Population estimates for different types of anaemia and their blood transfusion requirements were generated using local reference ranges (males <130 g litre-1; females <115 g litre-1). Results. One thousand three hundred and twenty-two admissions were included; haematology data were complete for 1142 (544 primary hip, 490 primary knee, 77 revision hip, 31 revision knee). About 19.6% were anaemic [7.1% haemoglobin (Hb) <110 g litre-1; 1.6% Hb<100 g litre-1]. Overall, 21.3% of admissions were transfused (mean 0.58 units per case: 95% CI 0.50-0.61). For anaemic admissions, 42.0% were transfused (mean 1.11 units per case: 95% CI 0.90-1.32). Mean red cell use for admissions with normocytic normochromic anaemia (12.7% of admissions) and hypochromic anaemia (4.6%) was 1.04 (95% CI 0.78-1.31) and 1.14 (95% CI 0.71-1.57) units per admission, respectively. Factors strongly associated independently with transfusion were preoperative haemoglobin ≤110 g litre-1 [odds ratio: 13.92 (95% CI 7.77-24.9) and revision hip surgery (OR: 17.80 (9.59-33.02)]. Conclusions. The prevalence of preoperative anaemia among admissions undergoing elective MJA is approximately 20%. Patients most likely to avoid transfusions with preoperative intervention are those with low haemoglobin undergoing revision hip surgery. © The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved.
Authors & Co-Authors
Saleh, E.
United Kingdom, Edinburgh
The University of Edinburgh
Egypt, Shibin el Kom
Menoufia University Faculty of Medicine
McClelland, D. B.L.
United Kingdom, Edinburgh
Scottish National Blood Transfusion Service
Hay, Alasdair W.
United Kingdom, Edinburgh
The University of Edinburgh
Semple, D.
United Kingdom, Edinburgh
The University of Edinburgh
Walsh, Timothy Simon
United Kingdom, Edinburgh
The University of Edinburgh
Statistics
Citations: 121
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1093/bja/aem299
ISSN:
00070912
e-ISSN:
14716771
Research Areas
Health System And Policy
Study Design
Randomised Control Trial
Cross Sectional Study
Case-Control Study
Participants Gender
Female