PMID- 20492612
OWN - NLM
STAT- MEDLINE
DCOM- 20101130
LR  - 20220310
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Linking)
VI  - 50
IP  - 10
DP  - 2010 Oct
TI  - Red blood cell transfusion practice in elective orthopedic surgery: a multicenter 
      cohort study.
PG  - 2117-24
LID - 10.1111/j.1537-2995.2010.02697.x [doi]
AB  - BACKGROUND: The indications for red blood cell (RBC) transfusions remain unclear 
      despite published guidelines. Our hypothesis was that the transfusion practice 
      varies inside the Centre hospitalier de l'Universite de Montreal (CHUM). STUDY 
      DESIGN AND METHODS: A total of 701 charts of patients who underwent a knee or hip 
      arthroplasty or prosthesis revision in three hospitals of the CHUM were reviewed. 
      Demography, hemoglobin (Hb) concentrations, details on transfusions, and 
      postoperative adverse events (AEs) were collected up until discharge. The primary 
      outcome was the presence or absence of RBC transfusion. Secondary outcomes were 
      the nadir Hb, number of units transfused, discharge Hb, blood losses, and 
      postoperative AEs. RESULTS: The rate of postoperative transfusion was 29%. We 
      found no significant difference between odds ratios of each site for sex, 
      coronary artery disease, chronic heart failure, type of procedure, American 
      Society of Anesthesiologists physical status, weight, height, body mass index, 
      body surface area, and estimated blood volume. Overall, patients were transfused 
      at a Hb between 75 and 80g/L. Eighty-five percent of postoperative transfusions 
      could be predicted using only nadir Hb and adding patient characteristics did not 
      substantially improve the model (86.1%). Discharge Hb was below 100g/L in 66% of 
      patients. CONCLUSIONS: There was no difference among hospitals regarding the way 
      RBC transfusions are used. Our data suggest that physicians mainly based their 
      decision to transfuse on a single variable, the Hb concentration, with the use of 
      a restrictive strategy. Future trials should focus on the optimal transfusion 
      trigger to adopt in major orthopedic surgery.
CI  - (c) 2010 American Association of Blood Banks.
FAU - Vuille-Lessard, Elise
AU  - Vuille-Lessard E
AD  - Department of Anesthesiology, CHUM Notre-Dame, University of Montreal, Montreal, 
      Quebec, Canada.
FAU - Boudreault, Daniel
AU  - Boudreault D
FAU - Girard, Francois
AU  - Girard F
FAU - Ruel, Monique
AU  - Ruel M
FAU - Chagnon, Miguel
AU  - Chagnon M
FAU - Hardy, Jean-Francois
AU  - Hardy JF
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20101004
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
SB  - IM
CIN - Transfusion. 2010 Oct;50(10):2073-5. doi: 10.1111/j.1537-2995.2010.02880.x. PMID: 
      21039578
MH  - Aged
MH  - Cohort Studies
MH  - Elective Surgical Procedures/*methods
MH  - Erythrocyte Transfusion/adverse effects/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Orthopedics/*methods
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2010/05/25 06:00
MHDA- 2010/12/14 06:00
CRDT- 2010/05/25 06:00
PHST- 2010/05/25 06:00 [entrez]
PHST- 2010/05/25 06:00 [pubmed]
PHST- 2010/12/14 06:00 [medline]
AID - TRF2697 [pii]
AID - 10.1111/j.1537-2995.2010.02697.x [doi]
PST - ppublish
SO  - Transfusion. 2010 Oct;50(10):2117-24. doi: 10.1111/j.1537-2995.2010.02697.x. Epub 
      2010 Oct 4.