Predictors of perioperative blood transfusions in patients with chronic kidney disease undergoing elective knee and hip arthroplasty

A. Graves, Piers Yates, Axel Hofmann, Shannon Farmer, Paolo Ferrari

    Research output: Contribution to journalArticle

    17 Citations (Scopus)

    Abstract

    Background Lower preoperative haemoglobin and older age pose a risk for perioperative allogeneic blood transfusions (ABT). The presence of chronic kidney disease (CKD) is associated with low haemoglobin, greater bleeding and ABT utilization. Study Design and Methods The interaction between estimated glomerular filtration rate (eGFR) and haemoglobin on perioperative ABT, length-of-stay and mortality was assessed in 86 patients with CKD stage 3 or higher undergoing elective total knee or hip arthroplasty compared with 294 without CKD. Multivariate analyses for ABT risk with haemoglobin, eGFR, age, gender, duration of surgery and primary versus revision surgery were performed. Results Patients with CKD had lower preoperative haemoglobin and higher incidence of ABT. Haemoglobin was independently associated with increased odds of ABT (0.74 (95% confidence interval 0.71-0.77), P=0.001), but eGFR was not (0.98 (0.96-1.02), P=0.089). Length-of-stay and 1 year mortality did not differ between non-transfused CKD patients and controls. Transfused CKD patients had significantly higher length-of-stay compared with transfused controls (25±21 vs 19±16 days, P
    Original languageEnglish
    Pages (from-to)404-409
    JournalNephrology
    Volume19
    Issue number7
    DOIs
    Publication statusPublished - 2014

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