Impact of hematologic disorders on decline in hemoglobin levels after total hip arthroplasty

ObjectiveBlood loss and postoperative anemia are common complications following total hip arthroplasty. Patients with hematologic disorders are at an increased risk of perioperative complications, especially those related to bleeding. This study aimed to investigate the impact of hematologic disorders on blood loss after total hip arthroplasty.MethodsThis single-center, matched retrospective cohort study included 64 patients who had undergone unilateral total hip arthroplasty for osteonecrosis of the femoral head. Patients were allocated in a 1:1 matched design to a control or a hematologic disorders group. Primary outcomes included postoperative red blood cell count, hemoglobin level, reductions in red blood cell count and hemoglobin level, postoperative drainage volume, transfusion rate, and estimated blood loss. Secondary outcomes comprised postoperative white blood cell and platelet counts, maximum perioperative changes, operative duration, length of hospital stay, and the incidence of lower-extremity deep venous thrombosis.ResultsPostoperative red blood cell counts and hemoglobin levels were significantly lower in the hematologic disorders group, and reduction in both parameters was more pronounced in this cohort. The rate of blood transfusion was also significantly higher in the hematologic disorders group. Postoperative white blood cell and platelet counts and perioperative changes in white blood cell counts were less favorable among patients with hematologic disorders. No statistically significant differences were detected in the operative duration, hospital stay, postoperative drainage volume, estimated blood loss, or incidence of lower-extremity deep venous thrombosis.ConclusionsPerioperative blood management following total hip arthroplasty may be more challenging in patients with hematologic disorders. Enhanced and targeted blood management strategies are warranted in this patient population.