2013, Number 6
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Acta Ortop Mex 2013; 27 (6)
Perioperative epidemiology of total hip arthroplasty
Mallen-Trejo A, Torres-Gómez A
Language: Spanish
References: 14
Page: 358-362
PDF size: 191.30 Kb.
ABSTRACT
An increasing number of patients require a prosthesis as a result of the increased physical demand seen in older patients, and the earlier diagnosis of conditions associated with hip arthrosis. It’s therefore essential to know the activity of various physiologic variables affecting the perioperative behavior of patients undergoing total hip arthroplasty.
Material and methods: An epidemiologic study was conducted to identify the absolute and relative frequencies of various variables during the perioperative period of total hip arthroplasty. The medical records of 142 patients who underwent total hip arthroplasty were analyzed.
Results: Of the 142 records analyzed, 91 cases were females (64.1%) and 51 males (35.9%); mean BMI was 27.16 kg/m2 (SD ± 3.98); 101 patients (71.1%) were overweight. The median preoperative Hb was 14.61 g/dl (range: 11-18.8 g/dl); the mean postoperative Hb was 10.76 g/dl (SD ± 1.56). The mean maximum permissible bleeding was 1,433.88 ml (SD ± 436.39). The median operative time was 150 minutes (range: 90-420 min).
Conclusion: We have to find ways to decrease the risk of major bleeding and thus avoid blood transfusions by knowing the characteristics of patients about to undergo total hip arthroplasty.
REFERENCES
1.Sacristán H, Imaz A, Martín S, Hermoso G, Represa F, Portal F, Martín M y cols: Tratado de patología y clínica quirúrgica. 2a edición. McGraw-Hill, 1992: 113-5.
2.Pola E, Papaleo P, Santoliquido A, Gasparini G, Aulisa L, De Santis E: Clinical factor associated with an increased of perioperative blood transfusion in nonanemic patients undergoing total hip arthroplasty. J Bone Joint Surg Am. 2004; 86-A(1): 57-61.
3.Grosflam JM, Wright EA, Cleary PD, Katz JN: Predictors of blood loss during total hip replacement surgery. Arthritis Care Res. 1995; 8(3): 167-73.
4.Schmied H, Kurz A, Sessler DI, Kozec S, Reiter A: Mild Hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet. 1996; 347(8997): 289-92.
5.Pagnano M, Cushner FD, Hansen A, Scuderi GR, Scott WN: Blood management in two-stage revision knee arthroplasty for deep prosthetic infection. Clin Orthop Relat Res. 1999; (367): 238-42.
6.Lemos MJ, Healy WL: Blood transfusion in orthoapedic operations. J Bone Joint Surg Am. 1996; 78(8): 1260-71
7.Woronoff-Lemsi MC, Arveux P, Limat S, Morel P, Le Pen C, Cahn JY: Erythropoietin and preoperative autologous blood donation in the prevention of hepatitis C infection: necessity or luxury? Transfusion. 1999; 39(9): 933-7.
8.Woolson ST, Marsh JS, Tanner JB: Transfusion of previously deposited autologous blood for patients undergoing hip replacement surgery. J Bone Joint Surg (Am). 1987; 69A: 325-8.
9.Ray JM, Flynn JC, Bierman AH: Erythrocyte survival following intraoperative autotransfusion in spinal surgery: an in vivo comparative study and 5 year update. Spine (Phila Pa 1976). 1986; 11(9): 879-82.
10.Edward AAR, Fredin H: Intraoperative autotransfusion in hip artroplasty: A retrospective study in 214 cases with matched controls. Acta Orthop Scand. 1992; 63(4): 369-72.
11.Law JK, Wiedel JD: Autotransfusion in revision total hip arthroplasties using uncemented prostheses. Clin Orthop Relat Res. 1989; 245: 145-9.
12.Guerra JJ, Cuckler JM: Cost-effectiveness of intraoperative autotransfusion in total hip arthroplasty surgery. Clin Orthop. 1995; 315: 212-22.
13.Llau JV, Aguilar G, Minguez MP, Reina C, Belda FJ, Gomar F: Técnicas de ahorro de sangre en cirugía ortopédica. Rev Esp Cir Osteoart. 1998; 33: 39-53.
14.Sharrock NE, Mineo R, Urquhart B, Salvati EA: The effect of two levels of hypotension on intraoperative blood loss during total hip arthroplasty performed under lumbar epidural anesthesia. Anesth Analg. 1993; 76: 580-4.