Curtin University Homepage
  • Library
  • Help
    • Admin

    espace - Curtin’s institutional repository

    JavaScript is disabled for your browser. Some features of this site may not work without it.
    View Item 
    • espace Home
    • espace
    • Curtin Research Publications
    • View Item
    • espace Home
    • espace
    • Curtin Research Publications
    • View Item

    Predictors of perioperative blood transfusions in patients with chronic kidney disease undergoing elective knee and hip arthroplasty

    Access Status
    Fulltext not available
    Authors
    Graves, A.
    Yates, P.
    Hofmann, Axel
    Farmer, Shannon
    Ferrari, P.
    Date
    2014
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Graves, A. and Yates, P. and Hofmann, A. and Farmer, S. and Ferrari, P. 2014. Predictors of perioperative blood transfusions in patients with chronic kidney disease undergoing elective knee and hip arthroplasty. Nephrology. 19 (7): pp. 404-409.
    Source Title
    Nephrology
    DOI
    10.1111/nep.12239
    ISSN
    1320-5358
    URI
    http://hdl.handle.net/20.500.11937/5866
    Collection
    • Curtin Research Publications
    Abstract

    Background: Lower preoperative haemoglobin and older age pose a risk for perioperative allogeneic blood transfusions (ABT). The presence of chronic kidney disease (CKD) is associated with low haemoglobin, greater bleeding and ABT utilization. Study Design and Methods: The interaction between estimated glomerular filtration rate (eGFR) and haemoglobin on perioperative ABT, length-of-stay and mortality was assessed in 86 patients with CKD stage 3 or higher under- going elective total knee or hip arthroplasty compared with 294 without CKD. Multivariate analyses for ABT risk with haemoglobin, eGFR, age, gender, duration of surgery and primary versus revision surgery were performed. Results: Patients with CKD had lower preoperative haemoglobin and higher incidence of ABT. Haemoglobin was independently associated with increased odds of ABT (0.74 (95% confidence interval 0.71–0.77), P = 0.001), but eGFR was not (0.98 (0.96–1.02), P = 0.089). Length-of-stay and 1 year mortality did not differ between non-transfused CKD patients and controls. Transfused CKD patients had significantly higher length-of-stay compared with transfused controls (25 ± 21 vs 19 ± 16 days, P<0.0001), although 1 year mortality between transfused CKD patients and controls did not differ significantly. Conclusion: CKD alone, in the absence of anaemia, does not predispose to increased risk of ABT or length-of-stay in patients with mild-to-moderate CKD undergoing elective joint surgery. However, low haemoglobin is associated with increased ABT utilization and increased length-of-stay. Considering that 1 in 4 patients undergoing elective hip or knee arthroplasty has CKD, optimal preoperative patient blood management may improve outcome in this population.

    Related items

    Showing items related by title, author, creator and subject.

    • Strategies to preempt and reduce the use of blood products: an Australian perspective
      Hofmann, Axel; Farmer, Shannon; Towler, Simon (2012)
      Purpose of review: Evidence-based patient blood management (PBM) is aimed at achieving better patient outcomes by relying on a patient's own blood rather than on donor blood. This review covers the rationale behind PBM, ...
    • Improved outcomes and reduced costs associated with a health-system–wide patient blood management program: a retrospective observational study in four major adult tertiary-care hospitals
      Leahy, M.; Hofmann, A.; Towler, S.; Trentino, K.; Burrows, S.; Swain, S.; Hamdorf, J.; Gallagher, T.; Koay, A.; Geelhoed, G.; Farmer, Shannon (2017)
      © 2017 The Authors Transfusion published by Wiley Periodicals, Inc. on behalf of AABB BACKGROUND: Patient blood management (PBM) programs are associated with improved patient outcomes, reduced transfusions and costs. In ...
    • Intravenous iron or placebo for anaemia in intensive care: the IRONMAN multicentre randomized blinded trial: A randomized trial of IV iron in critical illness
      The, I.; Litton, E.; Baker, S.; Erber, W.; Farmer, Shannon; Ferrier, J.; French, C.; Gummer, J.; Hawkins, D.; Higgins, A.; Hofmann, Axel; De Keulenaer, B.; McMorrow, J.; Olynyk, John; Richards, T.; Towler, S.; Trengove, R.; Webb, S.; The, A. (2016)
      Purpose: Both anaemia and allogenic red blood cell transfusion are common and potentially harmful in patients admitted to the intensive care unit. Whilst intravenous iron may decrease anaemia and RBC transfusion requirement, ...
    Advanced search

    Browse

    Communities & CollectionsIssue DateAuthorTitleSubjectDocument TypeThis CollectionIssue DateAuthorTitleSubjectDocument Type

    My Account

    Admin

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    Follow Curtin

    • 
    • 
    • 
    • 
    • 

    CRICOS Provider Code: 00301JABN: 99 143 842 569TEQSA: PRV12158

    Copyright | Disclaimer | Privacy statement | Accessibility

    Curtin would like to pay respect to the Aboriginal and Torres Strait Islander members of our community by acknowledging the traditional owners of the land on which the Perth campus is located, the Whadjuk people of the Nyungar Nation; and on our Kalgoorlie campus, the Wongutha people of the North-Eastern Goldfields.