Predictors and Outcomes of Postoperative Hemoglobin of <8 g/dL in Total Joint Arthroplasty

• DOI: 10.2106/jbjs.20.01766
• Publication Date: 2021-10-14T01:12:07Z
• Authors: Yash P. Chaudhry; Aoife MacMahon; Sandesh S. Rao; Kevin L. Mekkawy; Gregory R. Toci; Julius K. Oni; Robert S. Sterling; Harpal S. Khanuja
• Keywords: Joint arthroplasty

Restrictive transfusion practices have decreased transfusions in total joint arthroplasty (TJA). A hemoglobin threshold of <8 g/dL is commonly used. Predictors this degree postoperative anemia TJA and its association with outcomes, independent transfusions, remain unclear. We identified predictors outcomes without TJA.Primary elective cases performed a multimodal blood management protocol from 2017 to 2018 were reviewed, identifying 1,583 cases. Preoperative variables compared between patients ≥8 g/dL. Logistic regression receiver operating characteristic curves used assess g/dL.Positive preoperative level (odds ratio [OR] per 1.0-g/dL decrease, 3.0 [95% confidence interval (CI), 2.4 3.7]), hip (OR knee arthroplasty, 2.1 CI, 1.3 3.4]), operative time 30-minute increase, 2.0 1.6 2.6]). Negative tranexamic acid use (OR, 0.42 0.20 0.85]) body mass index 1 kg/m2 above normal, 0.90 0.86 0.94]). levels <12.4 women <13.4 men best predicted Overall, 5.2% 7 8 95% <7 received transfusions. Patients had longer hospital stays (p < 0.001) greater rates emergency department visits or readmissions = acute kidney injury 0.001). Among g/dL, who lower nadir stay 0.035) than did not receive transfusions.Postoperative after was associated worse even for do Optimizing may mitigate adverse outcomes.Prognostic Level IV. See Instructions Authors complete description evidence.