Frequency of Transfusions and Risk Factor for Bleeding Risk to Guide a Blood-Sparing Program during Hip Arthroplasty in Gabon
Frequency of Transfusions and Risk Factor for Bleeding Risk to Guide a Blood-Sparing Program during Hip Arthroplasty in Gabon作者机构：Department of Anaesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anaesthesia and Intensive Care Owendo University Hospital (CHUO) Libreville Gabon Department of Anaesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anaesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon Orthopedic surgery service Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon
出 版 物：《Open Journal of Anesthesiology》 (麻醉学期刊（英文）)
年 卷 期：2023年第13卷第3期
页 面：47-57页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Arthroplasty Hip Gabon Transfusion
摘 要：Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip arthroplasty in order to guide a blood-saving program. Method: Retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion data, anesthetic and intraoperative data. The primary outcome was intraoperative or postoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 276 patients included, 179 benefited from Total Hip Prosthesis (THP) and 97 from Intermediate Hip Prosthesis (IHP). Spinal anesthesia was performed in 67.4% of patients. The ASA 2 score predominated (65.9%). The transfusion incidence was 56.9% (157/276). Tranexamic acid was used in 16.3% (45/276) of patients. The average bleeding was 528 ± 405 ml. Preoperative anemia (OR = 0.78, 95% CI [0.66 - 0.91]) and total hip prosthesis (OR = 2.02 95% CI [1.11 - 3.67]) were predictors of bleeding and transfusion to be significant. The average serum hemoglobin predictive of a transfusion was 11.6 ± 1.8. ASA score and operative time were not found as risk factors for bleeding and transfusion. Conclusion: The incidence of transfusion is high. Preoperative anemia remains a major but modifiable risk factor unlike the choice of implant. The implementation of a patient blood management protocol could reduce this transfusion incidence.
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