Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database study
Abstract Objective This study sought to determine the incidence and risk factors of blood transfusion among patients undergoing total knee revision (TKR) using a nationwide database. Methods A retrospective data analysis was conducted based on the Nationwide Inpatient Sample (NIS), enrolling patient...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-07331-2 |
| _version_ | 1797247543472553984 |
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| author | Xiaoyin Li Hao Xie Shuxia Liu Jian Wang Zhanjun Shi Qiaobing Yao Qinfeng Yang Qiuhong Li Liangxiao Bao |
| author_facet | Xiaoyin Li Hao Xie Shuxia Liu Jian Wang Zhanjun Shi Qiaobing Yao Qinfeng Yang Qiuhong Li Liangxiao Bao |
| author_sort | Xiaoyin Li |
| collection | DOAJ |
| description | Abstract Objective This study sought to determine the incidence and risk factors of blood transfusion among patients undergoing total knee revision (TKR) using a nationwide database. Methods A retrospective data analysis was conducted based on the Nationwide Inpatient Sample (NIS), enrolling patients who underwent TKR from 2010 to 2019 with complete information. The patients were divided into two groups based on whether they received blood transfusion or not. The demographic characteristics (race, sex, and age), length of stay (LOS), total charge of hospitalization, hospital characteristics (admission type, insurance type, bed size, teaching status, location, and region of hospital), hospital mortality, comorbidities, and perioperative complications were analyzed. Finally, we conducted univariate and multivariate logistic regression to identify factors that were associated with TKR patients to require blood transfusion. Results The NIS database included 115,072 patients who underwent TKR. Among them, 14,899 patients received blood transfusion, and the incidence of blood transfusion was 13.0%. There was a dramatic decrease in the incidence over the years from 2010 to 2019, dropping from 20.4 to 6.5%. TKR patients requiring transfusions had experienced longer LOS, incurred higher total medical expenses, utilized Medicare more frequently, and had increased in-hospital mortality rates (all P < 0.001). Independent predictors for blood transfusion included advanced age, female gender, iron-deficiency anemia, rheumatoid disease, chronic blood loss anemia, congestive heart failure, coagulopathy, uncomplicated diabetes, lymphoma, fluid and electrolyte disorders, metastatic carcinoma, other neurological diseases, paralysis, peripheral vascular disorders, pulmonary circulation disorders, renal failure, valvular disease, and weight loss. In addition, risk factors for transfusion in TKR surgery included sepsis, acute myocardial infarction, deep vein thrombosis, pulmonary embolism, gastrointestinal bleeding, heart failure, renal insufficiency, pneumonia, wound infection, lower limb nerve injury, hemorrhage/seroma/hematoma, wound rupture/non healing, urinary tract infection, acute renal failure, and postoperative delirium. Conclusions Our findings highlight the importance of recognizing the risk factors of blood transfusion in TKR to reduce the occurrence of adverse events. |
| first_indexed | 2024-04-24T20:00:22Z |
| format | Article |
| id | doaj.art-70473015779f4d4ebba740b8206c719c |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-24T20:00:22Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-70473015779f4d4ebba740b8206c719c2024-03-24T12:08:08ZengBMCBMC Musculoskeletal Disorders1471-24742024-03-0125111510.1186/s12891-024-07331-2Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database studyXiaoyin Li0Hao Xie1Shuxia Liu2Jian Wang3Zhanjun Shi4Qiaobing Yao5Qinfeng Yang6Qiuhong Li7Liangxiao Bao8Division of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityAbstract Objective This study sought to determine the incidence and risk factors of blood transfusion among patients undergoing total knee revision (TKR) using a nationwide database. Methods A retrospective data analysis was conducted based on the Nationwide Inpatient Sample (NIS), enrolling patients who underwent TKR from 2010 to 2019 with complete information. The patients were divided into two groups based on whether they received blood transfusion or not. The demographic characteristics (race, sex, and age), length of stay (LOS), total charge of hospitalization, hospital characteristics (admission type, insurance type, bed size, teaching status, location, and region of hospital), hospital mortality, comorbidities, and perioperative complications were analyzed. Finally, we conducted univariate and multivariate logistic regression to identify factors that were associated with TKR patients to require blood transfusion. Results The NIS database included 115,072 patients who underwent TKR. Among them, 14,899 patients received blood transfusion, and the incidence of blood transfusion was 13.0%. There was a dramatic decrease in the incidence over the years from 2010 to 2019, dropping from 20.4 to 6.5%. TKR patients requiring transfusions had experienced longer LOS, incurred higher total medical expenses, utilized Medicare more frequently, and had increased in-hospital mortality rates (all P < 0.001). Independent predictors for blood transfusion included advanced age, female gender, iron-deficiency anemia, rheumatoid disease, chronic blood loss anemia, congestive heart failure, coagulopathy, uncomplicated diabetes, lymphoma, fluid and electrolyte disorders, metastatic carcinoma, other neurological diseases, paralysis, peripheral vascular disorders, pulmonary circulation disorders, renal failure, valvular disease, and weight loss. In addition, risk factors for transfusion in TKR surgery included sepsis, acute myocardial infarction, deep vein thrombosis, pulmonary embolism, gastrointestinal bleeding, heart failure, renal insufficiency, pneumonia, wound infection, lower limb nerve injury, hemorrhage/seroma/hematoma, wound rupture/non healing, urinary tract infection, acute renal failure, and postoperative delirium. Conclusions Our findings highlight the importance of recognizing the risk factors of blood transfusion in TKR to reduce the occurrence of adverse events.https://doi.org/10.1186/s12891-024-07331-2Blood transfusionTotal knee revisionRisk factorsIncidenceNationwide inpatient sample |
| spellingShingle | Xiaoyin Li Hao Xie Shuxia Liu Jian Wang Zhanjun Shi Qiaobing Yao Qinfeng Yang Qiuhong Li Liangxiao Bao Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database study BMC Musculoskeletal Disorders Blood transfusion Total knee revision Risk factors Incidence Nationwide inpatient sample |
| title | Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database study |
| title_full | Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database study |
| title_fullStr | Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database study |
| title_full_unstemmed | Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database study |
| title_short | Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database study |
| title_sort | analysis of the incidence and risk factors of blood transfusion in total knee revision a retrospective nationwide inpatient sample database study |
| topic | Blood transfusion Total knee revision Risk factors Incidence Nationwide inpatient sample |
| url | https://doi.org/10.1186/s12891-024-07331-2 |
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