Fewer blood transfusions after introduction of auto-transfusion system as part of hip- and knee-replacement surgery

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 153; p. B187
• Main Authors: Hendriks, Hans G E, van Erve, Ruud H G P, Salden, Har, van der Zwet, Wil C, Barnaart, Lex F W
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 2009
• Subjects: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Blood Loss, Surgical; Blood Transfusion - statistics & numerical data; Blood Transfusion - utilization; Blood Transfusion, Autologous - statistics & numerical data; Blood Transfusion, Autologous - utilization; Female; Humans; Logistic Models; Male; Multivariate Analysis; Prospective Studies; Risk Factors; Utilization Review - statistics & numerical data
• ISSN: 0028-2162; 1876-8784

To establish the effect of the introduction of an auto-transfusion system on the number of homologous blood transfusions required as part of total hip- and knee-replacement surgery.
Prospective observational study.
The number of homologous blood transfusions required after total hip or knee replacement was compared between a group of 195 patients before and a group of 176 patients after introduction of an auto-transfusion system. The '4-5-6 Flexinorm' was strictly implemented when deciding to use homologous blood transfusion. Composition of the groups and the number of transfusion units of homologous blood (packed cells) required were compared using Student's t test and the chi2 test. In addition multivariate logistic regression analysis was used with the following variables as risk factors for requirement of homologous blood transfusion: gender, age, type of surgery and the use of an auto-transfusion system.
After introduction of the auto-transfusion system there was a reduction in the number of transfusion units given in both the hip- and the knee-replacement group (83% and 98% respectively). The use of the auto-transfusion system was the only variable for prediction of the requirement for homologous blood transfusion in the logistic regression model.
After the introduction of an auto-transfusion system there was a reduction in the number of homologous blood transfusions required as part of total hip and knee surgery.