Prolonged operative time increases risk of blood loss and transfusion requirements in revision hip surgery
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ORIGINAL ARTICLE
Prolonged operative time increases risk of blood loss and transfusion requirements in revision hip surgery Jonathan Manara1 · Harvey Sandhu2 · Michael Wee3 · Adekoyejo Odutola4 · Thomas Wainwright5,7 · Charles Knowles6 · Robert Middleton5,8 Received: 8 August 2019 / Accepted: 22 April 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Introduction Revision hip surgery is well documented to have a high association with substantial blood loss and the associated need for a blood transfusion. This exposes the patient to increased risk of transfusion reaction and blood borne infection. There are many strategies to minimize allogeneic transfusion rates in revision surgery such as pre-operative autologous donation, peri-operative tranexamic acid, thrombin sealants, normovolaemic haemodilution, intra-operative blood salvage and the use of post-operative autologous drains. Patients and methods We prospectively looked at 177 consecutive cases performed at one centre by a single surgical and anaesthetic team to identify which patient and operative factors were most significant in minimizing the requirement for an allogeneic blood transfusion. Results Our results identified the duration of surgery as being the only significant variable affecting the level of blood loss. We noted a 3% increase in the probability of massive blood loss (> 2000 mls) for every minute of increased surgical time in our series. Conclusions We conclude that measures to minimize the duration of surgery would be beneficial in reducing blood loss and the risks of requiring blood transfusions in revision hip surgery. Keywords Blood-loss · Hip · Revision · Arthroplasty · Transfusion · Complications
2
Royal United Hospital, Combe Park, Bath BA1 3NG, UK
3
Harvey Sandhu [email protected]
Poole Hospital NHS Foundation Trust, Bournemouth University, Poole BH15 2JB, UK
4
Michael Wee [email protected]
Weston General Hospital, Grange Rd, Weston‑super‑Mare BS23 4TQ, UK
5
Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth BH8 8EB, UK
Thomas Wainwright [email protected] https://staffprofiles.bournemouth.ac.uk/display/twainwright
6
Barts and The London School of Medicine and Dentistry, 1st Floor, Abernethy Building, 2 Newark Street, London E1 2AT, UK
Charles Knowles [email protected]
7
Physiotherapy Department, The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Castle Lane East, Bournemouth BH7 7DW, UK
8
Orthopaedic Department, The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Castle Lane East, Bournemouth BH7 7DW, UK
* Jonathan Manara [email protected]
Adekoyejo Odutola [email protected]
Robert Middleton [email protected] https://staffprofiles.bournemouth.ac.uk/display/rmiddleton 1
Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK
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Introduction Revision hip
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