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Disparities Associated With Total Joint Arthroplasty Transfusion Rates
Shelby H Meckstroth1, Andrew G Chapple1, Vinod Dasa1
1Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana.
The Journal of Arthroplasty
|September 17, 2023
Summary
Transfusion rates after joint replacement surgery are decreasing. However, Black patients still receive transfusions more often than White patients, indicating ongoing disparities in care.
Area of Science:
- Orthopedic Surgery
- Health Equity
- Transfusion Medicine
Background:
- Transfusions after total joint arthroplasty (TJA) are linked to increased complications.
- Certain demographic groups, including Black patients, face higher transfusion risks.
- Recent trends show declining transfusion rates and a focus on medical equity.
Purpose of the Study:
- To investigate persistent disparities in transfusion rates among TJA patients.
- To identify factors influencing transfusion rates over time.
Main Methods:
- Analysis of 5,435 total knee arthroplasty (TKA) and 2,105 total hip arthroplasty (THA) patients (2013-2021).
- Comparison of transfusion rates between racial groups using statistical tests.
- Multivariable logistic regression to identify predictors of transfusion.
Main Results:
- Overall transfusion rates decreased during the study period.
- Black patients had significantly higher transfusion rates than White patients in the TKA group (5.1% vs 1.8%).
- Being Black was the strongest predictor of higher transfusion risk in TKA patients after adjustment (aOR=2.2).
Conclusions:
- While TJA transfusion rates are declining, disparities persist.
- Black patients undergoing TKA continue to experience higher rates of transfusion compared to White patients.
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