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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Preoperative hematocrit on early prosthetic joint infection and deep venous thrombosis rates in primary total hip
Bradley W Wills1, Jeffrey Pearson1, Alan Hsu2
1Department of Orthopedics, University of Alabama Birmingham, United States.
Background:
Total hip arthroplasty (THA) is a very successful surgery in restoring a patient's quality of life. Infection is a devastating complication of THA. Many risks factors for infection in THA have been identified but little is known of the effect by preoperative hematocrit.
Purpose:
We aimed to evaluate the effect of preoperative hematocrit on early superficial site infections, deep infections, and deep organ space infections.
Methods:
Our study cohort included patients undergoing a THA in the ACS National Surgical Quality Improvement Program database from 2006 to 2015. We conducted a multivariate logistic regression analysis to evaluate an association between preoperative hematocrit and infection controlling for patients demographics and known risk factors.
Results:
A total of 98,869 patients were identified in this study. Of these, 702 (0.71%) developed a superficial site infection, 314 (0.32%) a deep infection, and 226 (0.23%) an organ space infection. Our results suggested a significant increased risk of deep infection (OR = 2.38, p = 0.0120) and organ space infection (OR = 3.05, p = 0.0234) in patients with lower preoperative hematocrit (<41). In addition, patients with lower preoperative hematocrit had higher chance to receive postoperative transfusion (OR = 2.93, p < 0.0001). However, no significant associations between preoperative hematocrit and superficial site infections (p = 0.8554), wound dehiscence (p = 0.0660) and DVT (p = 0.9236) were detected.
Conclusion:
Low preoperative hematocrit is associated with increased risk of deep, organ space infections, and postoperative transfusion in THA, but not with superficial site infections, wound dehiscence and DVT.
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