Analysis of a large data set to identify predictors of blood transfusion in primary total hip and knee arthroplasty

Transfusion
ZeYu HuangFuXing Pei

Abstract

The aim of this study was to identify the predictors of need for allogenic blood transfusion (ALBT) in primary lower limb total joint arthroplasty (TJA). This study utilized a large dataset of 15,187 patients undergoing primary unilateral TJA. Risk factors and demographic information were extracted from the electronic health record. A predictive model was developed by both a random forest (RF) algorithm and logistic regression (LR). The area under the receiver operating characteristic curve (AUC-ROC) was used to compare the accuracy of the two methods. The rate of ALBT was 18.9% in total. Patient-related factors associated with higher risk of an ALBT included female sex, American Society of Anesthesiologists (ASA) II, ASA III, and ASA IV. Surgery-related risk factors for ALBT were operative time, drain use, and amount of intraoperative blood loss. Higher preoperative hemoglobin and tranexamic acid use were associated with decreased risk for ALBT. The RF model had a better predictive accuracy (area under the curve [AUC] 0.84) than the LR model (AUC, 0.77; p < 0.001). The risk factors identified in the current study can provide specific, personalized perioperative ALBT risk assessment for a patient considering lower limb TJA. Fur...Continue Reading

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Citations

Jan 9, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Armin ArshiAdam A Sassoon
May 20, 2020·Acta ortopedica brasileira·Chilan Bou Ghosson LeiteRiccardo Gomes Gobbi
Jun 27, 2019·Journal of Orthopaedic Surgery and Research·Hong XuFuxing Pei
Jul 1, 2020·Transfusion·Andreas MittereckerJens Meier
Dec 15, 2019·Orthopaedics & Traumatology, Surgery & Research : OTSR·Pierre Dao, Philippe Massin
Dec 8, 2020·Geriatric Orthopaedic Surgery & Rehabilitation·Aris LuangwaranyooVarah Yuenyongviwat
Jun 22, 2021·Expert Review of Medical Devices·Thibault DhalluinLeslie Grammatico-Guillon
May 29, 2020·American Journal of Infection Control·Ana Isabel Hijas-GómezGil Rodríguez-Caravaca

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