This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Feagan, B. G.
Right arrow Articles by Turner, K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Feagan, B. G.
Right arrow Articles by Turner, K.
Related Collections
Right arrow Hematologic pathology (including blood transfusion)
Right arrow Orthopedic & trauma surgery
CMAJ • February 5, 2002; 166 (3)
© 2002 Canadian Medical Association or its licensors

Research
Recherche

Transfusion practices for elective orthopedic surgery

Brian G. Feagan*{dagger}, Cindy J. Wong*, William C. Johnston{ddagger}, Ramiro Arellano§, Nigel Colterjohn, Keyvan Karkouti** and Kim Turner{dagger}{dagger}

From *the London Clinical Trials Research Group, John P. Robarts Research Institute, London, Ont.; {dagger}the Departments of Medicine and of Epidemiology and Biostatistics, University of Western Ontario, London, Ont.; {ddagger}the Department of Orthopedics, University of Alberta Hospital, University of Alberta, Edmonton, Alta.; §the Department of Anaesthesia, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS; ¶the Department of Surgery, Hamilton Health Sciences Corporation, McMaster University, Hamilton, Ont.; **the Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ont.; and {dagger}{dagger}the Department of Anaesthesia, Queen's University, Kingston, Ont.

Correspondence to: Dr. Brian G. Feagan, Professor of Medicine, Department of Epidemiology and Biostatistics, Director, London Clinical Trials Research Group, John P. Robarts Research Institute, PO Box 5015, 100 Perth Dr., London ON N6A 5K8

Background: Use of blood conservation techniques in elective surgery reduces the risk of infection and transfusion reactions that result from using allogeneic blood products. We examined the transfusion practice and blood conservation strategies for elective orthopedic procedures in 19 Canadian hospitals.

Methods: We reviewed the medical records of patients who underwent total hip or knee joint arthroplasty between June 1998 and January 1999 in a convenience sample of 19 hospitals to determine the pre- and postoperative hemoglobin concentrations, concurrent medical conditions, participation status in an autologous blood donation program, use of other blood conservation techniques, and occurrence of allogeneic and autologous transfusions. Patients were considered eligible for autologous blood donation if they weighed at least 25 kg, were in good general health without major cardiac conditions and had a hemoglobin concentration of at least 110 g/L.

Results: We reviewed 4535 medical records. Of the 4422 patients whose eligibility status was known, 2561 (57.9%) were eligible to participate in an autologous blood donation program. Only 842 (18.6%) of the patients predonated blood. Patients who did not predonate blood were older (mean age 70.1 v. 63.8 years) and were more likely to have concomitant medical conditions (60.3% v. 37.9%) than those who did predonate. Overall, 30.6% (95% confidence interval [CI] 29.1%–32.1%) of the patients who did not predonate blood received allogeneic transfusions. For patients who predonated, the rate of allogeneic transfusion was 14.1% (95% CI 11.8%–16.5%). The frequency with which blood conservation techniques other than autologous blood donation were used was minimal (in 2.4% of all cases).

Interpretation: The use of blood conservation techniques among hospitals in Canada remains low. Only a minority of eligible patients participated in an autologous blood donation program.




This article has been cited by other articles:


Home page
 JBJSHome page
J. L. Pierson, T. J. Hannon, and D. R. Earles
A Blood-Conservation Algorithm to Reduce Blood Transfusions After Total Hip and Knee Arthroplasty
J. Bone Joint Surg. Am., July 1, 2004; 86(7): 1512 - 1518.
[Abstract] [Full Text] [PDF]

Home page
 CMAJHome page
B. Borghi and H. v. Oven
Reducing the risk of allogeneic blood transfusion
Can. Med. Assoc. J., February 1, 2002; 166(3): 332 - 334.
[Full Text]