Identification of the haemoglobin level associated with a lower risk of complications after total hip and knee arthroplasty
Background Preoperative anaemia is associated with poor outcomes in surgical patients, but the preoperative haemoglobin cut‐off that determines lower morbidity in total knee arthroplasty (TKA) and total hip arthroplasty (THA) is not well established. Methods Planned secondary analysis of data collec...
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| Veröffentlicht in: | Acta anaesthesiologica Scandinavica 2023-05, Vol.67 (5), p.629-639 |
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| creator | Abad‐Motos, Ane Ripollés‐Melchor, Javier Jericó, Carlos Bisbe, Elvira Basora, Misericordia Colomina, Maria J. Becerra‐Bolaños, Ángel Bermúdez‐López, María Massa‐Gómez, Cristina Albaladejo‐Magdalena, Javier Solar‐Herrera, Ana Pérez‐Chrzanowska, Hanna Yárnoz, Carlos Fedriani‐de‐Matos, Jacobo José Blanco‐Del‐Val, Beatriz Fabián‐González, David Bellver, Jorge Redondo‐Enríquez, Juan M. Serrat‐Puyol, Jordi Abad‐Gurumeta, Alfredo Zorrilla‐Vaca, Andrés Aldecoa, César García‐Erce, José Antonio |
| description | Background
Preoperative anaemia is associated with poor outcomes in surgical patients, but the preoperative haemoglobin cut‐off that determines lower morbidity in total knee arthroplasty (TKA) and total hip arthroplasty (THA) is not well established.
Methods
Planned secondary analysis of data collected during a multicentre cohort study of patients undergoing THA and TKA in 131 Spanish hospitals during a single 2‐month recruitment period. Anaemia was defined as haemoglobin |
| doi_str_mv | 10.1111/aas.14217 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2777404595</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2777404595</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3887-b43cdaa58e121891209c7e731bffe7ee3e0be4572c82090c50b26e5a0e08a0ed3</originalsourceid><addsrcrecordid>eNp1kcFu1DAQhi0EokvhwAsgS1zoIa0dx3F8XFVQKlXiAJytiTMhbp042F5WK14el104IOHDWNZ882nkn5DXnF3ycq4A0iVvaq6ekA0XWletVO1TsmGM8UpyVZ-RFyndl6dotH5OzkSrtGSN3JCftwMu2Y3OQnZhoWGkeUI6Ac7hmw-9W6jHH-gppBSsg4wD3bs8UaA-7DHS6NLD45QN8-pPlkRhzKWXQwZPJ7dSWAb6sCBSiHmKYfWQ8uEleTaCT_jqdJ-Trx_ef7n-WN19urm93t5VVnSdqvpG2AFAdshr3mleM20VKsH7cUSFKJD12EhV2660mJWsr1uUwJB1pQzinLw7etcYvu8wZTO7ZNF7WDDskqmVUk35DS0L-vYf9D7s4lK2M3XHRK1azVWhLo6UjSGliKNZo5shHgxn5jERUxIxvxMp7JuTcdfPOPwl_0RQgKsjsHceD_83me3281H5C5nxllU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2803276917</pqid></control><display><type>article</type><title>Identification of the haemoglobin level associated with a lower risk of complications after total hip and knee arthroplasty</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Abad‐Motos, Ane ; Ripollés‐Melchor, Javier ; Jericó, Carlos ; Bisbe, Elvira ; Basora, Misericordia ; Colomina, Maria J. ; Becerra‐Bolaños, Ángel ; Bermúdez‐López, María ; Massa‐Gómez, Cristina ; Albaladejo‐Magdalena, Javier ; Solar‐Herrera, Ana ; Pérez‐Chrzanowska, Hanna ; Yárnoz, Carlos ; Fedriani‐de‐Matos, Jacobo José ; Blanco‐Del‐Val, Beatriz ; Fabián‐González, David ; Bellver, Jorge ; Redondo‐Enríquez, Juan M. ; Serrat‐Puyol, Jordi ; Abad‐Gurumeta, Alfredo ; Zorrilla‐Vaca, Andrés ; Aldecoa, César ; García‐Erce, José Antonio</creator><creatorcontrib>Abad‐Motos, Ane ; Ripollés‐Melchor, Javier ; Jericó, Carlos ; Bisbe, Elvira ; Basora, Misericordia ; Colomina, Maria J. ; Becerra‐Bolaños, Ángel ; Bermúdez‐López, María ; Massa‐Gómez, Cristina ; Albaladejo‐Magdalena, Javier ; Solar‐Herrera, Ana ; Pérez‐Chrzanowska, Hanna ; Yárnoz, Carlos ; Fedriani‐de‐Matos, Jacobo José ; Blanco‐Del‐Val, Beatriz ; Fabián‐González, David ; Bellver, Jorge ; Redondo‐Enríquez, Juan M. ; Serrat‐Puyol, Jordi ; Abad‐Gurumeta, Alfredo ; Zorrilla‐Vaca, Andrés ; Aldecoa, César ; García‐Erce, José Antonio ; POWER2 Study Investigators Group ; the POWER2 Study Investigators Group</creatorcontrib><description>Background
Preoperative anaemia is associated with poor outcomes in surgical patients, but the preoperative haemoglobin cut‐off that determines lower morbidity in total knee arthroplasty (TKA) and total hip arthroplasty (THA) is not well established.
Methods
Planned secondary analysis of data collected during a multicentre cohort study of patients undergoing THA and TKA in 131 Spanish hospitals during a single 2‐month recruitment period. Anaemia was defined as haemoglobin <12 g dl−1 for females and < 13 g dl−1 for males. The primary outcome was the number of patients with 30‐day in‐hospital postoperative complications according to European Perioperative Clinical Outcome definitions and specific surgical TKA and THA complications. Secondary outcomes included the number of patients with 30‐day moderate‐to‐severe complications, red blood cell transfusion, mortality, and length of hospital stay. Binary logistic regression models were constructed to assess association between preoperative Hb concentrations and postoperative complications, and variables significantly associated with the outcome were included in the multivariate model. The study sample was divided into 11 groups based on preoperative Hb values in an effort to identify the threshold at which increased postoperative complications occurred.
Results
A total of 6099 patients were included in the analysis (3818 THA and 2281 TKA), of whom 8.8% were anaemic. Patients with preoperative anaemia were more likely to suffer overall complications (111/539, 20.6% vs. 563/5560, 10.1%, p < .001) and moderate‐to‐severe complications (67/539, 12.4% vs. 284/5560, 5.1%, p < .001). Multivariable analysis showed preoperative haemoglobin ≥14 g dl−1 was associated with fewer postoperative complications.
Conclusion
Preoperative haemoglobin ≥14 g dl−1 is associated with a lower risk of postoperative complications in patients undergoing primary TKA and THA.</description><identifier>ISSN: 0001-5172</identifier><identifier>EISSN: 1399-6576</identifier><identifier>DOI: 10.1111/aas.14217</identifier><identifier>PMID: 36795045</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>anaemia ; Anemia ; Anemia - complications ; Anemia - epidemiology ; Arthroplasty (knee) ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Knee - adverse effects ; Biomedical materials ; Blood Transfusion ; Cohort Studies ; Complications ; Erythrocytes ; Female ; Hemoglobin ; Hemoglobins ; Hip ; Humans ; Joint replacement surgery ; Knee ; Length of Stay ; Male ; Morbidity ; Orthopaedic implants ; orthopaedic surgery ; outcomes ; patient blood management ; Patients ; Postoperative ; postoperative complications ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Regression analysis ; Secondary analysis ; Total hip arthroplasty ; total knee arthroplasty</subject><ispartof>Acta anaesthesiologica Scandinavica, 2023-05, Vol.67 (5), p.629-639</ispartof><rights>2023 Acta Anaesthesiologica Scandinavica Foundation.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3887-b43cdaa58e121891209c7e731bffe7ee3e0be4572c82090c50b26e5a0e08a0ed3</citedby><cites>FETCH-LOGICAL-c3887-b43cdaa58e121891209c7e731bffe7ee3e0be4572c82090c50b26e5a0e08a0ed3</cites><orcidid>0000-0001-6723-7350 ; 0000-0002-2817-3144 ; 0000-0003-1049-4027 ; 0000-0002-9644-2887 ; 0000-0003-0106-0956 ; 0000-0002-1892-5330</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Faas.14217$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faas.14217$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36795045$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abad‐Motos, Ane</creatorcontrib><creatorcontrib>Ripollés‐Melchor, Javier</creatorcontrib><creatorcontrib>Jericó, Carlos</creatorcontrib><creatorcontrib>Bisbe, Elvira</creatorcontrib><creatorcontrib>Basora, Misericordia</creatorcontrib><creatorcontrib>Colomina, Maria J.</creatorcontrib><creatorcontrib>Becerra‐Bolaños, Ángel</creatorcontrib><creatorcontrib>Bermúdez‐López, María</creatorcontrib><creatorcontrib>Massa‐Gómez, Cristina</creatorcontrib><creatorcontrib>Albaladejo‐Magdalena, Javier</creatorcontrib><creatorcontrib>Solar‐Herrera, Ana</creatorcontrib><creatorcontrib>Pérez‐Chrzanowska, Hanna</creatorcontrib><creatorcontrib>Yárnoz, Carlos</creatorcontrib><creatorcontrib>Fedriani‐de‐Matos, Jacobo José</creatorcontrib><creatorcontrib>Blanco‐Del‐Val, Beatriz</creatorcontrib><creatorcontrib>Fabián‐González, David</creatorcontrib><creatorcontrib>Bellver, Jorge</creatorcontrib><creatorcontrib>Redondo‐Enríquez, Juan M.</creatorcontrib><creatorcontrib>Serrat‐Puyol, Jordi</creatorcontrib><creatorcontrib>Abad‐Gurumeta, Alfredo</creatorcontrib><creatorcontrib>Zorrilla‐Vaca, Andrés</creatorcontrib><creatorcontrib>Aldecoa, César</creatorcontrib><creatorcontrib>García‐Erce, José Antonio</creatorcontrib><creatorcontrib>POWER2 Study Investigators Group</creatorcontrib><creatorcontrib>the POWER2 Study Investigators Group</creatorcontrib><title>Identification of the haemoglobin level associated with a lower risk of complications after total hip and knee arthroplasty</title><title>Acta anaesthesiologica Scandinavica</title><addtitle>Acta Anaesthesiol Scand</addtitle><description>Background
Preoperative anaemia is associated with poor outcomes in surgical patients, but the preoperative haemoglobin cut‐off that determines lower morbidity in total knee arthroplasty (TKA) and total hip arthroplasty (THA) is not well established.
Methods
Planned secondary analysis of data collected during a multicentre cohort study of patients undergoing THA and TKA in 131 Spanish hospitals during a single 2‐month recruitment period. Anaemia was defined as haemoglobin <12 g dl−1 for females and < 13 g dl−1 for males. The primary outcome was the number of patients with 30‐day in‐hospital postoperative complications according to European Perioperative Clinical Outcome definitions and specific surgical TKA and THA complications. Secondary outcomes included the number of patients with 30‐day moderate‐to‐severe complications, red blood cell transfusion, mortality, and length of hospital stay. Binary logistic regression models were constructed to assess association between preoperative Hb concentrations and postoperative complications, and variables significantly associated with the outcome were included in the multivariate model. The study sample was divided into 11 groups based on preoperative Hb values in an effort to identify the threshold at which increased postoperative complications occurred.
Results
A total of 6099 patients were included in the analysis (3818 THA and 2281 TKA), of whom 8.8% were anaemic. Patients with preoperative anaemia were more likely to suffer overall complications (111/539, 20.6% vs. 563/5560, 10.1%, p < .001) and moderate‐to‐severe complications (67/539, 12.4% vs. 284/5560, 5.1%, p < .001). Multivariable analysis showed preoperative haemoglobin ≥14 g dl−1 was associated with fewer postoperative complications.
Conclusion
Preoperative haemoglobin ≥14 g dl−1 is associated with a lower risk of postoperative complications in patients undergoing primary TKA and THA.</description><subject>anaemia</subject><subject>Anemia</subject><subject>Anemia - complications</subject><subject>Anemia - epidemiology</subject><subject>Arthroplasty (knee)</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Biomedical materials</subject><subject>Blood Transfusion</subject><subject>Cohort Studies</subject><subject>Complications</subject><subject>Erythrocytes</subject><subject>Female</subject><subject>Hemoglobin</subject><subject>Hemoglobins</subject><subject>Hip</subject><subject>Humans</subject><subject>Joint replacement surgery</subject><subject>Knee</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Morbidity</subject><subject>Orthopaedic implants</subject><subject>orthopaedic surgery</subject><subject>outcomes</subject><subject>patient blood management</subject><subject>Patients</subject><subject>Postoperative</subject><subject>postoperative complications</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Regression analysis</subject><subject>Secondary analysis</subject><subject>Total hip arthroplasty</subject><subject>total knee arthroplasty</subject><issn>0001-5172</issn><issn>1399-6576</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFu1DAQhi0EokvhwAsgS1zoIa0dx3F8XFVQKlXiAJytiTMhbp042F5WK14el104IOHDWNZ882nkn5DXnF3ycq4A0iVvaq6ekA0XWletVO1TsmGM8UpyVZ-RFyndl6dotH5OzkSrtGSN3JCftwMu2Y3OQnZhoWGkeUI6Ac7hmw-9W6jHH-gppBSsg4wD3bs8UaA-7DHS6NLD45QN8-pPlkRhzKWXQwZPJ7dSWAb6sCBSiHmKYfWQ8uEleTaCT_jqdJ-Trx_ef7n-WN19urm93t5VVnSdqvpG2AFAdshr3mleM20VKsH7cUSFKJD12EhV2660mJWsr1uUwJB1pQzinLw7etcYvu8wZTO7ZNF7WDDskqmVUk35DS0L-vYf9D7s4lK2M3XHRK1azVWhLo6UjSGliKNZo5shHgxn5jERUxIxvxMp7JuTcdfPOPwl_0RQgKsjsHceD_83me3281H5C5nxllU</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Abad‐Motos, Ane</creator><creator>Ripollés‐Melchor, Javier</creator><creator>Jericó, Carlos</creator><creator>Bisbe, Elvira</creator><creator>Basora, Misericordia</creator><creator>Colomina, Maria J.</creator><creator>Becerra‐Bolaños, Ángel</creator><creator>Bermúdez‐López, María</creator><creator>Massa‐Gómez, Cristina</creator><creator>Albaladejo‐Magdalena, Javier</creator><creator>Solar‐Herrera, Ana</creator><creator>Pérez‐Chrzanowska, Hanna</creator><creator>Yárnoz, Carlos</creator><creator>Fedriani‐de‐Matos, Jacobo José</creator><creator>Blanco‐Del‐Val, Beatriz</creator><creator>Fabián‐González, David</creator><creator>Bellver, Jorge</creator><creator>Redondo‐Enríquez, Juan M.</creator><creator>Serrat‐Puyol, Jordi</creator><creator>Abad‐Gurumeta, Alfredo</creator><creator>Zorrilla‐Vaca, Andrés</creator><creator>Aldecoa, César</creator><creator>García‐Erce, José Antonio</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6723-7350</orcidid><orcidid>https://orcid.org/0000-0002-2817-3144</orcidid><orcidid>https://orcid.org/0000-0003-1049-4027</orcidid><orcidid>https://orcid.org/0000-0002-9644-2887</orcidid><orcidid>https://orcid.org/0000-0003-0106-0956</orcidid><orcidid>https://orcid.org/0000-0002-1892-5330</orcidid></search><sort><creationdate>202305</creationdate><title>Identification of the haemoglobin level associated with a lower risk of complications after total hip and knee arthroplasty</title><author>Abad‐Motos, Ane ; Ripollés‐Melchor, Javier ; Jericó, Carlos ; Bisbe, Elvira ; Basora, Misericordia ; Colomina, Maria J. ; Becerra‐Bolaños, Ángel ; Bermúdez‐López, María ; Massa‐Gómez, Cristina ; Albaladejo‐Magdalena, Javier ; Solar‐Herrera, Ana ; Pérez‐Chrzanowska, Hanna ; Yárnoz, Carlos ; Fedriani‐de‐Matos, Jacobo José ; Blanco‐Del‐Val, Beatriz ; Fabián‐González, David ; Bellver, Jorge ; Redondo‐Enríquez, Juan M. ; Serrat‐Puyol, Jordi ; Abad‐Gurumeta, Alfredo ; Zorrilla‐Vaca, Andrés ; Aldecoa, César ; García‐Erce, José Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3887-b43cdaa58e121891209c7e731bffe7ee3e0be4572c82090c50b26e5a0e08a0ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>anaemia</topic><topic>Anemia</topic><topic>Anemia - complications</topic><topic>Anemia - epidemiology</topic><topic>Arthroplasty (knee)</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Biomedical materials</topic><topic>Blood Transfusion</topic><topic>Cohort Studies</topic><topic>Complications</topic><topic>Erythrocytes</topic><topic>Female</topic><topic>Hemoglobin</topic><topic>Hemoglobins</topic><topic>Hip</topic><topic>Humans</topic><topic>Joint replacement surgery</topic><topic>Knee</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Morbidity</topic><topic>Orthopaedic implants</topic><topic>orthopaedic surgery</topic><topic>outcomes</topic><topic>patient blood management</topic><topic>Patients</topic><topic>Postoperative</topic><topic>postoperative complications</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Regression analysis</topic><topic>Secondary analysis</topic><topic>Total hip arthroplasty</topic><topic>total knee arthroplasty</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abad‐Motos, Ane</creatorcontrib><creatorcontrib>Ripollés‐Melchor, Javier</creatorcontrib><creatorcontrib>Jericó, Carlos</creatorcontrib><creatorcontrib>Bisbe, Elvira</creatorcontrib><creatorcontrib>Basora, Misericordia</creatorcontrib><creatorcontrib>Colomina, Maria J.</creatorcontrib><creatorcontrib>Becerra‐Bolaños, Ángel</creatorcontrib><creatorcontrib>Bermúdez‐López, María</creatorcontrib><creatorcontrib>Massa‐Gómez, Cristina</creatorcontrib><creatorcontrib>Albaladejo‐Magdalena, Javier</creatorcontrib><creatorcontrib>Solar‐Herrera, Ana</creatorcontrib><creatorcontrib>Pérez‐Chrzanowska, Hanna</creatorcontrib><creatorcontrib>Yárnoz, Carlos</creatorcontrib><creatorcontrib>Fedriani‐de‐Matos, Jacobo José</creatorcontrib><creatorcontrib>Blanco‐Del‐Val, Beatriz</creatorcontrib><creatorcontrib>Fabián‐González, David</creatorcontrib><creatorcontrib>Bellver, Jorge</creatorcontrib><creatorcontrib>Redondo‐Enríquez, Juan M.</creatorcontrib><creatorcontrib>Serrat‐Puyol, Jordi</creatorcontrib><creatorcontrib>Abad‐Gurumeta, Alfredo</creatorcontrib><creatorcontrib>Zorrilla‐Vaca, Andrés</creatorcontrib><creatorcontrib>Aldecoa, César</creatorcontrib><creatorcontrib>García‐Erce, José Antonio</creatorcontrib><creatorcontrib>POWER2 Study Investigators Group</creatorcontrib><creatorcontrib>the POWER2 Study Investigators Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Acta anaesthesiologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abad‐Motos, Ane</au><au>Ripollés‐Melchor, Javier</au><au>Jericó, Carlos</au><au>Bisbe, Elvira</au><au>Basora, Misericordia</au><au>Colomina, Maria J.</au><au>Becerra‐Bolaños, Ángel</au><au>Bermúdez‐López, María</au><au>Massa‐Gómez, Cristina</au><au>Albaladejo‐Magdalena, Javier</au><au>Solar‐Herrera, Ana</au><au>Pérez‐Chrzanowska, Hanna</au><au>Yárnoz, Carlos</au><au>Fedriani‐de‐Matos, Jacobo José</au><au>Blanco‐Del‐Val, Beatriz</au><au>Fabián‐González, David</au><au>Bellver, Jorge</au><au>Redondo‐Enríquez, Juan M.</au><au>Serrat‐Puyol, Jordi</au><au>Abad‐Gurumeta, Alfredo</au><au>Zorrilla‐Vaca, Andrés</au><au>Aldecoa, César</au><au>García‐Erce, José Antonio</au><aucorp>POWER2 Study Investigators Group</aucorp><aucorp>the POWER2 Study Investigators Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identification of the haemoglobin level associated with a lower risk of complications after total hip and knee arthroplasty</atitle><jtitle>Acta anaesthesiologica Scandinavica</jtitle><addtitle>Acta Anaesthesiol Scand</addtitle><date>2023-05</date><risdate>2023</risdate><volume>67</volume><issue>5</issue><spage>629</spage><epage>639</epage><pages>629-639</pages><issn>0001-5172</issn><eissn>1399-6576</eissn><abstract>Background
Preoperative anaemia is associated with poor outcomes in surgical patients, but the preoperative haemoglobin cut‐off that determines lower morbidity in total knee arthroplasty (TKA) and total hip arthroplasty (THA) is not well established.
Methods
Planned secondary analysis of data collected during a multicentre cohort study of patients undergoing THA and TKA in 131 Spanish hospitals during a single 2‐month recruitment period. Anaemia was defined as haemoglobin <12 g dl−1 for females and < 13 g dl−1 for males. The primary outcome was the number of patients with 30‐day in‐hospital postoperative complications according to European Perioperative Clinical Outcome definitions and specific surgical TKA and THA complications. Secondary outcomes included the number of patients with 30‐day moderate‐to‐severe complications, red blood cell transfusion, mortality, and length of hospital stay. Binary logistic regression models were constructed to assess association between preoperative Hb concentrations and postoperative complications, and variables significantly associated with the outcome were included in the multivariate model. The study sample was divided into 11 groups based on preoperative Hb values in an effort to identify the threshold at which increased postoperative complications occurred.
Results
A total of 6099 patients were included in the analysis (3818 THA and 2281 TKA), of whom 8.8% were anaemic. Patients with preoperative anaemia were more likely to suffer overall complications (111/539, 20.6% vs. 563/5560, 10.1%, p < .001) and moderate‐to‐severe complications (67/539, 12.4% vs. 284/5560, 5.1%, p < .001). Multivariable analysis showed preoperative haemoglobin ≥14 g dl−1 was associated with fewer postoperative complications.
Conclusion
Preoperative haemoglobin ≥14 g dl−1 is associated with a lower risk of postoperative complications in patients undergoing primary TKA and THA.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36795045</pmid><doi>10.1111/aas.14217</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-6723-7350</orcidid><orcidid>https://orcid.org/0000-0002-2817-3144</orcidid><orcidid>https://orcid.org/0000-0003-1049-4027</orcidid><orcidid>https://orcid.org/0000-0002-9644-2887</orcidid><orcidid>https://orcid.org/0000-0003-0106-0956</orcidid><orcidid>https://orcid.org/0000-0002-1892-5330</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Acta anaesthesiologica Scandinavica, 2023-05, Vol.67 (5), p.629-639 |
| issn | 0001-5172 1399-6576 |
| language | eng |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | anaemia Anemia Anemia - complications Anemia - epidemiology Arthroplasty (knee) Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Knee - adverse effects Biomedical materials Blood Transfusion Cohort Studies Complications Erythrocytes Female Hemoglobin Hemoglobins Hip Humans Joint replacement surgery Knee Length of Stay Male Morbidity Orthopaedic implants orthopaedic surgery outcomes patient blood management Patients Postoperative postoperative complications Postoperative Complications - epidemiology Postoperative Complications - etiology Regression analysis Secondary analysis Total hip arthroplasty total knee arthroplasty |
| title | Identification of the haemoglobin level associated with a lower risk of complications after total hip and knee arthroplasty |
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