Transfusion in orthopaedic surgery : a retrospective multicentre cohort study

Area of Science:

• Orthopaedic Surgery
• Transfusion Medicine
• Healthcare Management

Background:

• Orthopaedic surgeries are complex procedures often leading to significant blood loss and perioperative transfusions.
• Contemporary transfusion practices require updated understanding due to evolving surgical techniques and transfusion guidelines.

Purpose of the Study:

• To describe current transfusion practices in orthopaedic surgery.
• To inform perioperative planning and blood banking resource allocation.

Main Methods:

• Retrospective cohort study of adult patients undergoing nonarthroscopic joint surgeries, amputations, and fracture surgeries.
• Data collected from four Canadian hospitals between 2014 and 2016.
• Analysis of red blood cell (RBC), platelet, and plasma transfusion proportions and volumes.

Main Results:

• 10.3% of 14,584 patients received RBC transfusions, with rates varying by surgery type (0.0%–33.1%).
• Hip fracture surgery had the highest transfusion rate (25.0%) and accounted for 38.0% of all RBC units transfused.
• Primary knee and hip arthroplasties had low in-hospital transfusion rates (2.8% and 4.5%, respectively). Platelet and plasma transfusions were infrequent.

Conclusions:

• Transfusion rates in orthopaedic surgery are highly dependent on the specific surgical procedure.
• Identifying high-transfusion-risk surgeries is crucial for effective perioperative planning.
• Further research into factors influencing transfusion in at-risk populations can optimize transfusion mitigation strategies and blood bank management.