Postoperative Recovery of Blood in Patients Undergoing Total Knee or Hip Arthroplasty

Hugo Laranjeira, Celeste Coimbra, Nuno Fernandes, Romeu Pinho, Rui Anjos, Elisabeth Mesquita, António Barros, Rita Ferreira, Lúcia Borges


Background: In total knee arthroplasty and total hip arthroplasty occurs a considerable loss of blood, which often requires homologous transfusions of red blood cells. However, homologous transfusions have risks, besides being expensive and a limited resource. Thus, in order to reduce the need for homologous transfusions alternatives strategies have been developed, like post-operative recovery of blood.
Objectives: Evaluation of post-operative recovery of blood in postoperatively red blood cells consumption and in hospital stay, by a retrospective analysis of patients undergoing total knee arthroplasty or total hip arthroplasty.
Material and Methods: Patients (n = 976) were divided in 2 groups: CELL TRANS – after implementation of postoperative recovery of blood and CONT – before implementation of the strategy. The red blood cells requests to Serviço de Imunohemoterapia gave the number of RBC units administered and the length of hospital stay was obtained through the Sistema de Apoio ao Médico. Statistical analysis was performed using the R language, considering significant differences between groups when p values < 0,05.
Results: After the introduction of this strategy, 29% of patients undergoing total knee arthroplasty and 38% of patients undergoing total hip arthroplasty received red blood cells in the postoperative period, a number considerably lower to that observed before the implementation of post-operative recovery of blood, 68% and 59% respectively. Concomitantly, there was a statistically significant reduction in the length of stay of 9.0 to 8.3 days in the case of total knee arthroplasty patients and from 9.1 to 8.8 days in the case of patients undergoing total hip arthroplasty.
Conclusion: Post-operative recovery of blood in patients undergoing total knee arthroplasty or total hip arthroplasty significantly reduces the need for red blood cells transfusion and the length of hospital stay.

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