Advertisement

Archives of Orthopaedic and Trauma Surgery

, Volume 124, Issue 10, pp 699–701 | Cite as

The influence of preclinical anaemia on outcome following total hip replacement

  • E. MyersEmail author
  • P. O. Grady
  • A. M. Dolan
Original Article

Abstract

Introduction

Preoperative anaemia confers a higher intraoperative and postoperative risk of complications on a patient. Preclinical anaemia is defined as a patient with laboratory indices of anaemia but without any of the symptoms. The patient population who undergo total hip replacement (THR) are elderly and are more likely to fall into this category. Our aim was to assess the effect of preclinical anaemia on a patient’s postoperative course.

Materials and methods

A prospective analysis of elective THRs performed over a 10-month period was carried out. Preoperative haematological indices were recorded and correlated with postoperative complication rates.

Results

A total of 225 elective THRs were included in the study. Patients with preclinical anaemia on admission had a higher incidence of postoperative infection and transfusion (p<0.001) and a longer postoperative inpatient stay. Preoperative iron supplementation in patients with preclinical iron deficiency anaemia resulted in a reduction in transfusion requirements (p=0.00125).

Conclusions

Identification and treatment of patients with preclinical anaemia preoperatively may reduce postoperative infection and transfusion needs and result in a shorter inpatient stay.

Keywords

Anaemia Total hip replacement Transfusion Infection 

References

  1. 1.
    Andrews EM, Lane DW, Bradley JG (1997) Iron pre-load for major joint replacement. Transfus Med 4:281–286CrossRefGoogle Scholar
  2. 2.
    Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB (1999) An analysis of blood management in patients having total hip or knee arthroplasty. J Bone Joint Surg Am 81:2–10PubMedGoogle Scholar
  3. 3.
    Carson JL, Poses RM, Spence RK, Boavista G (1988) Severity of anaemia and operative anaemia and operative mortality. Lancet 1:727–729CrossRefPubMedGoogle Scholar
  4. 4.
    Dunne JR, Malone D, Tracy JK, Gannon C, Napolitano CM (2002) Preoperative anaemia: an independent risk factor for infection, mortality and resource utilization in surgery. J Surg Res 102:237–244CrossRefPubMedGoogle Scholar
  5. 5.
    Healy WL (1995) Economic considerations in total hip arthroplasty and implant standardisation. Clin Orthop 311:102–108PubMedGoogle Scholar
  6. 6.
    Keating EM, Meding JB, Faris PM, Ritter MA (1998) Predictors of transfusion risk in elective knee surgery. Clin Orthop 357:50–59CrossRefPubMedGoogle Scholar
  7. 7.
    Salido JA, Martin LA, Gomez LA (2002) Preoperative hemoglobin levels and the need for transfusion after prosthetic hip and knee surgery: analysis of predictive factors. J Bone Joint Surg Am 2:216–220Google Scholar
  8. 8.
    Trinlzi DJ, Blumberg N, Heal JM (1990) Association of transfusion with postoperative bacterial infection. Crit Rev Clin Lab Sci 28:95–107PubMedGoogle Scholar
  9. 9.
    Williamson LM, Lowe S, Love EM, Cohen H, Solden K, McCelland DB, Skacel P, Barbara JA (1999) Serious hazards of transfusion (SHOT) initiative: analysis of the first two annual reports. BMJ 319:16–19PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Regional Orthopaedic UnitOur Lady’s HospitalNavanIreland
  2. 2.North Strand, Dublin 3Ireland

Personalised recommendations