Incidence and risk factors for blood transfusion insimultaneous bilateral total hip arthroplasty

Abstract

Objectives: This study aims to investigate the incidence and riskfactors for blood transfusion in patients undergoing simultaneousbilateral total hip arthroplasty (SimBTHA). Patients and methods: Between January 2011 and June 2021,a total of 341 patients (289 males, 52 females; median age:53 years; range, 43 to 66 years) who underwent SimBTHAwere retrospectively analyzed. The patients were divided intotwo groups as those who did and did not require allogeneicblood transfusion. Univariate and multivariate logistic regressionmodels were used to identify independent risk factors fortransfusion. Results: The incidence of transfusion in SimBTHA was12.9%. We found that a higher preoperative hemoglobin level(odds ratio [OR]: 0.91; 95% confidence interval [CI]: 0.86-0.96),tranexamic acid (TXA) use (OR: 0.25; 95% CI: 0.09-0.58), andintraoperative autologous blood transfusion from a closed suctiondrainage system (OR: 0.30; 95% CI: 0.09-0.80) were protectiveagainst the need for transfusion in patients after SimBTHA.In addition, drainage use (OR: 3.52; 95% CI: 1.49-8.32) andintraoperative blood loss (OR: 1.17; 95% CI: 1.04-1.33) were theindependent risk factors for blood transfusion. Conclusion: The risk factors for transfusion after SimBTHAshould be evaluated to establish specific, personalized transfusionrisk assessments for each individual patient. For SimBTHA, themain risk factors include intraoperative bleeding and the useof drainage tube, while higher preoperative hemoglobin levels,TXA use, and autologous blood transfusion from a closed suctiondrainage system may reduce transfusion risk.