Blood transfusion associated with shoulder arthroplasty

Area of Science:

• Orthopedic Surgery
• Transfusion Medicine
• Patient Blood Management

Background:

• High transfusion rates are reported in shoulder arthroplasty.
• This study aimed to evaluate institutional transfusion rates and identify risk factors.
• Investigated changes in transfusion rates and demographics over time.

Purpose of the Study:

• To determine the transfusion rate in shoulder arthroplasty at the institution.
• To confirm known predictors of transfusion.
• To assess temporal trends in transfusion rates and associated factors.

Main Methods:

• Retrospective review of 366 shoulder arthroplasties (total, hemi, revision, reverse).
• Logistic regression analysis to identify transfusion predictors.
• Comparison of early (1996-2005) and late (2006-2009) patient groups.

Main Results:

• Overall transfusion rate was 7.4%.
• Predictors of transfusion included higher intraoperative blood loss, low preoperative hemoglobin, and humeral cement fixation.
• No difference in transfusion rates between early and late groups; late group showed increased general anesthesia with regional block, blood loss, and VTE prophylaxis.

Conclusions:

• Low preoperative hemoglobin, significant intraoperative blood loss, and humeral cement fixation are key predictors of transfusion.
• Transfusion rates were not influenced by procedure type, female sex, increasing age, or comorbidities.
• While overall transfusion rates remained stable, anesthetic techniques and blood loss patterns evolved.