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Intermediate Hip Arthroplasty in Gabon: Blood loss and Risk Factor for Transfusion

Open Journal of Anesthesiology 2024年第4期14卷 109-117页

作者： Ghislain Edjo Nkilly Pascal Christian Nze Obiang Raphael Okoue Ondo Arthur Matsanga Stéphane Oliveira léandre nguiabanda Jean-Marcel Mandji-lawson Department of Anaesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anaesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anaesthesia and Intensive Care Owendo University Hospital (CHUO) 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

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 hemiarthroplasty in Gabon. Method: It was a 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 and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.

关键词： Hip Arthroplasty Risk Factors Patients Hemiarthroplasty Gabon

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Frequency of Transfusions and Risk Factor for Bleeding Risk to Guide a Blood-Sparing Program during Hip Arthroplasty in Gabon

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Open Journal of Anesthesiology 2023年第3期13卷 47-57页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Arthur Matsanga Pascal Christian Nze Obiang Stéphane Oliveira léandre nguiabanda Jean-Marcel Mandji-lawson Romain Tchoua 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

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.

关键词： Arthroplasty Hip Gabon Transfusion

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