An Analysis of Overtransfusion in Total Hip Replacement Surgery / 대한마취과학회지

ABSTRACT

BACKGROUND: This study was designed to identify overtransfusion- triggering clinical factors in patients undergoing total hip replacement surgery. METHODS: The discharge hematocrit was chosen for evaluation. Estimated red cell loss for each patient during the admission was calculated by the differences between admission and discharge hematocrit, multiplied by patient whole blood volume. Total RBC lost was then determined by the sum of RBC volume lost plus the RBC volume transfused. RBC transfusion was considered appropriate if given to replace RBC volume lost in excess of 15% of the RBC volume in each patient at admission. Comparison of transfusion practice was done on the basis of sex, age, preoperative hematocrit, surgical procedure and anesthetic method. RESULTS: Forty-six (37.7%) of 122 patients were identified to have been transfused with red cell volumes in excess of red cell volumes lost. Significant differences for patients transfused in excess of needs were found by sex (52.4% of women vs. 22.0% of men, P = 0.001) and by preoperative hematocrit (71.4% of patients with lower hematocrit vs. 24.1% of patients with higher hematocrit, P = 0.001). CONCLUSIONS: Preoperative hematocrit and sex can be a overtransfusion-triggering index.