Tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a real-world study
Abstract Background In an enhanced recovery after surgery program, a growing number of orthopedists are reconsidering the necessity of tourniquet use in total knee arthroplasty (TKA). However, the impact of tourniquet use on transfusion rate and postoperative length of stay (PLOS) in TKA remains con...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03623-5 |
| _version_ | 1818313247543001088 |
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| author | Hong Xu Jingli Yang Jinwei Xie Zeyu Huang Qiang Huang Guorui Cao Fuxing Pei |
| author_facet | Hong Xu Jingli Yang Jinwei Xie Zeyu Huang Qiang Huang Guorui Cao Fuxing Pei |
| author_sort | Hong Xu |
| collection | DOAJ |
| description | Abstract Background In an enhanced recovery after surgery program, a growing number of orthopedists are reconsidering the necessity of tourniquet use in total knee arthroplasty (TKA). However, the impact of tourniquet use on transfusion rate and postoperative length of stay (PLOS) in TKA remains controversial. Therefore, we carried out a study to investigate the effect of tourniquet application in routine primary TKA on transfusion rate and PLOS. Methods We analyzed data from 6325 patients who underwent primary unilateral TKA and divided them into two groups according to whether a tourniquet was applied during the procedure, and a tourniquet was used in 4902 and not used in 1423. The information for transfusion and PLOS was extracted from patients’ electronic health records, and the data were analyzed with logistic and linear regression analyses. Results Following TKA, the transfusion rate and PLOS were 14.52% and 7.72 ± 3.54 days, respectively, in the tourniquet group, and 6.47% and 6.44 ± 3.48 days, respectively, in the no-tourniquet group. After adjusting for the different related variables, tourniquet use was significantly correlated with a higher transfusion rate (risk ratio = 1.888, 95% confidence interval (CI) 1.449–2.461, P < 0.001) and a longer PLOS (partial regression coefficient (B) = 0.923, 95%CI 0.690–1.156, P < 0.001). Conclusions Our findings suggested that tourniquet use in routine primary TKA was related to a higher transfusion rate and a longer PLOS. The impact of tourniquet use on transfusion rate and PLOS should be taken into account in clinical practice. |
| first_indexed | 2024-12-13T08:30:43Z |
| format | Article |
| id | doaj.art-e947e3955975495ba83aed8a6e646aee |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-13T08:30:43Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-e947e3955975495ba83aed8a6e646aee2022-12-21T23:53:47ZengBMCBMC Musculoskeletal Disorders1471-24742020-09-012111810.1186/s12891-020-03623-5Tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a real-world studyHong Xu0Jingli Yang1Jinwei Xie2Zeyu Huang3Qiang Huang4Guorui Cao5Fuxing Pei6Department of Orthopaedic surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan UniversityCollege of Earth and Environmental Sciences, School of Public Health, Lanzhou UniversityDepartment of Orthopaedic surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan UniversityDepartment of Orthopaedic surgery, West China Hospital, Sichuan UniversityDepartment of Orthopaedic surgery, West China Hospital, Sichuan UniversityDepartment of Orthopaedic surgery, West China Hospital, Sichuan UniversityDepartment of Orthopaedic surgery, West China Hospital, Sichuan UniversityAbstract Background In an enhanced recovery after surgery program, a growing number of orthopedists are reconsidering the necessity of tourniquet use in total knee arthroplasty (TKA). However, the impact of tourniquet use on transfusion rate and postoperative length of stay (PLOS) in TKA remains controversial. Therefore, we carried out a study to investigate the effect of tourniquet application in routine primary TKA on transfusion rate and PLOS. Methods We analyzed data from 6325 patients who underwent primary unilateral TKA and divided them into two groups according to whether a tourniquet was applied during the procedure, and a tourniquet was used in 4902 and not used in 1423. The information for transfusion and PLOS was extracted from patients’ electronic health records, and the data were analyzed with logistic and linear regression analyses. Results Following TKA, the transfusion rate and PLOS were 14.52% and 7.72 ± 3.54 days, respectively, in the tourniquet group, and 6.47% and 6.44 ± 3.48 days, respectively, in the no-tourniquet group. After adjusting for the different related variables, tourniquet use was significantly correlated with a higher transfusion rate (risk ratio = 1.888, 95% confidence interval (CI) 1.449–2.461, P < 0.001) and a longer PLOS (partial regression coefficient (B) = 0.923, 95%CI 0.690–1.156, P < 0.001). Conclusions Our findings suggested that tourniquet use in routine primary TKA was related to a higher transfusion rate and a longer PLOS. The impact of tourniquet use on transfusion rate and PLOS should be taken into account in clinical practice.http://link.springer.com/article/10.1186/s12891-020-03623-5TourniquetKneeArthroplastyTransfusionLength of stay |
| spellingShingle | Hong Xu Jingli Yang Jinwei Xie Zeyu Huang Qiang Huang Guorui Cao Fuxing Pei Tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a real-world study BMC Musculoskeletal Disorders Tourniquet Knee Arthroplasty Transfusion Length of stay |
| title | Tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a real-world study |
| title_full | Tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a real-world study |
| title_fullStr | Tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a real-world study |
| title_full_unstemmed | Tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a real-world study |
| title_short | Tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay: a real-world study |
| title_sort | tourniquet use in routine primary total knee arthroplasty is associated with a higher transfusion rate and longer postoperative length of stay a real world study |
| topic | Tourniquet Knee Arthroplasty Transfusion Length of stay |
| url | http://link.springer.com/article/10.1186/s12891-020-03623-5 |
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