Preoperative Predictors of Aderinto and Brenkel for Blood Transfusion After a Unilateral Total Hip Replacement
Purpose: To identify a patient undergoing unilateral hip replacement who is likely to be transfused based on preoperative factors as reported by Aderinto and Brenkel.
Aderinto and Brenkel identified preoperative factors associated with the need for blood transfusion after a unilateral total hip replacement. The authors are from Queen Margaret Hospital in Dunfermline, Scotland.
Risk factors identified on multivariate analysis:
(1) preoperative hemoglobin < 12 g/dL (a mild increase is seen with hemoglobin in the 12-12.9 g/dL range)
(2) body weight < 70 kilograms
Parameters covered by these 2 risk factors:
(1) female gender
(2) older age
(3) lower height and body mass index (BMI)
Additional factors affecting blood transfusion:
(1) bilateral surgery (vs unilateral replacement)
(2) availability of autologous units (a factor seen in the previous section on spinal fusion surgery)
By restricting type and crossmatch to patients with a preoperative hemoglobin < 11 g/dL the number of units crossmatched could be reduced by 78%.
For the implementation I will recommend type and crossmatch if the preoperative hemoglobin is < 12 g/dL or (hemoglobin < 13 g/dL AND weight < 70 kg), else type and screen.
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Purpose: To identify a patient undergoing unilateral hip replacement who is likely to be transfused based on preoperative factors as reported by Aderinto and Brenkel.
Specialty: Clinical Laboratory, General Surgery, Anesthesiology, Emergency Medicine, Critical Care
