Arthroscopy & Arthroplasty.
David Ross; Omer Erkocak; Mohammad R. Rasouli; Javad Parvizi
Volume 7, Issue 3 , May 2019, , Pages 229-234
Abstract
Background: Allogeneic blood transfusion in patients undergoing total joint arthroplasty (TJA) has been shown tonegatively affect patient outcomes. This study aimed to examine if there is a correlation between operative time and theneed for allogeneic blood transfusions during TJA.Methods: We performed ...
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Background: Allogeneic blood transfusion in patients undergoing total joint arthroplasty (TJA) has been shown tonegatively affect patient outcomes. This study aimed to examine if there is a correlation between operative time and theneed for allogeneic blood transfusions during TJA.Methods: We performed a retrospective review of 866 patients who underwent primary TJA during a one-year periodat our institution. Logistic regression was performed to identify the association between operative time and need forallogeneic blood transfusion, controlling for other patient and surgical factors. Multiple linear regression analysis wasalso performed to see how the same factors affected CBL.Results: Of the 866 cases, 13%(115) were simultaneous bilateral. 52%(449) of patients received preoperativeautologous blood donation. The average operative time for unilateral and bilateral patients was 74.1±(33.9) and132.6±(36.0) minutes, respectively. Average CBL for unilateral patients was 2120mL±(1208) and 4051mL±(1311) forbilateral cases. The average number of allogeneic transfusions was also higher within the bilateral group (0.49 vs 1.15units). Multivariate analysis indicated that duration of surgery (odds ratio [OR]:1.35 per 15 minutes) and bilateral TJA(OR: 2.97) increase the risk of allogeneic blood transfusion, while patients having total knee arthroplasty are less likelyto receive allogeneic blood transfusion (OR: 0.50). CBL also increased significantly with surgical duration (211.5 mLper 15 minutes).Conclusion: A subgroup analysis confirmed that there was a correlation between operative time and need forallogeneic transfusion following unilateral TJA. Expeditious surgery can minimize blood loss and subsequent need forblood transfusion and its associated adverse consequences.
Shoulder
John G. Horneff; Usman Ali Syed; Adam Seidl; Jessica Britton; Gerald Williams; Joseph Abboud
Volume 7, Issue 1 , January and February 2019, , Pages 12-18
Abstract
Background: The purpose of this study was to determine a correlation between surgical case order and the length ofoperative time, total length of time in the operating room, time until discharge from the hospital, and the incidence ofintraoperative complications for primary total shoulder arthroplasty ...
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Background: The purpose of this study was to determine a correlation between surgical case order and the length ofoperative time, total length of time in the operating room, time until discharge from the hospital, and the incidence ofintraoperative complications for primary total shoulder arthroplasty cases.Methods: A retrospective review was conducted of records for all individual primary total shoulder arthroplasty andreverse total shoulder arthroplasty at a single hospital. In order to compare true parameters and minimize variables,only the cases performed by one senior author were analyzed. Operative and hospital records were reviewed.Results: There were 162 primary TSA and with the following order: 55 first order cases, 46 second order cases, 34third order cases, 21 fourth order cases, and six fifth order cases. There were 71 primary rTSA patients included (27:27:10:6:1). Length of stay was statistically increased for both female gender (8.3%; 95% confidence interval (CI)= 0.5-16.7%; P=0.0386) and fourth case order compared to first case (13.3%; 95% CI = 0.6%; 27.6%) P=0.041). For reverseTSA, there was no analyzed predictor that was significant.Conclusion: Even between anatomic TSA and reverse TSA patients, there was variability in what factors played apart in case inpatient length of stay. As such, we believe that this study highlights that case order can have an effecton operating room parameters for shoulder arthroplasty patients. The need for larger studies remains to better definethat effect.Level of evidence: IV