Risk factors of blood transfusion following primary total hip replacement

Total hip replacement is a quality of life-enhancing procedure. Postoperative blood transfusion is a risk factor compromising the outcome of total hip replacement and increasing the risk of deep infection. The aim of this study is to determine the risk factors for postoperative blood transfusion after total hip replacement.

In this retrospective study, 3901 patients underwent primary total hip replacement, in the period between January 2015 and December 2023. The mean age of the participants was 67.3 (SD: 12.6) years, and 61% of them were females. Participants were divided into 'transfusion' and 'non-transfusion' groups.

Forty-two patients (1.1%) received blood transfusion after total hip replacement. In a multivariable logistic regression analysis, preoperative haemoglobin was the only independent risk factor that reduced the odds of postoperative transfusion by 0.3 (95% confidence interval: 0.23-0.39) for every 1 g/dL increase.

Postoperative blood transfusion is a rare, yet potentially serious, occurrence after total hip replacement. In this study, preoperative haemoglobin level was the only independent risk factor associated with postoperative transfusion. We recommend aiming to achieve minimum preoperative haemoglobin level of 13 g/dL to minimise the risk of postoperative transfusion.