Decrease Incidence of Blood Transfusion In Hip Arthroplasty Patients Due To Combined Blood Saving Measures

ABSTRACT

Background: Hip arthritis is a common and crippling disease causing severe pain, deformity and significant disability. Worldwide arthroplasty is among the commonest orthopaedic surgeries of degenerated hip that can result in considerable blood loss. This results in a postoperative decline in haemoglobin levels of 3.0 to 4.0 gram/decilitre from preoperative haemoglobin levels of 14.0 gram/decilitre on an average. Postoperative anaemia may seriously decrease functional mobility in the early postoperative phase following total hip arthroplasty. In recent years there has been an increasing awareness and positive attitude toward blood-saving measures. Blood-saving techniques can be broadly divided into preoperative, intraoperative and postoperative measures in total hip arthroplasty. Our aim is to assess the Decrease incidence of blood transfusion in hip arthroplasty patients due to combined blood saving measures. Methods: The study was a hospital based prospective observational study conducted during the period of March 2015 to august 2017 in the department of orthopedics, Patna medical college and hospital, Patna. Patients between the age of 50-85 years were included who underwent total hip arthroplasty between March 2015 to august 2017 in the department of orthopedics, Patna medical college and hospital, Patna. Patients were selected as per inclusion and exclusion. Surgery was done. Preoperative, intraoperative and postoperative blood saving modality was used in total hip arthroplasty. Blood loss and Blood transfusion assessment was done. Results: In this study out of 38 patients, Female were 26 (68.4%) and Male were 12 (31.6%). 26.3 % (10/38) patients were between 50-60 years of age, 47.4 % (18/38) between 61-70 years of age, 21.0 % (8/38) between 71-80 years of age and 5.3 % (2/38) patients above 81 years of age. left total hip replacement was done in 14/38 (36.8%), right total hip replacement was done in 24/38(63.2%) patients.Anaesthesia given was Combined spinal epidural=22/38(57.9%), spinal anaesthesia+ block=12/38 (31.6 %), spinal anaesthesia=2/38 (5.3 %), general anaesthesia+ block=2/38 (5.3 %). Mean diastolic blood pressure was 81.60 millimetre of mercury pre op and intra op 71.11. Mean systolic blood pressure was 135.51 millimetre of mercury pre op and intra op 98.02. In this study only 1 patient out of 38 patients were subjected to blood transfusion accounting to 2.6 % which was statistically significant. Conclusion:Use of combined blood saving measures helps to decrease incidence of blood transfusion in arthroplasty. Due to low incidence of blood transfusion, blood related adverse event is prevented. There was statistically significant reduction in haemoglobin level after operation. There was statistically significant reduction in haematocrit level after operation.