How Does Preoperative Anemia Impact Clinical Outcomes Following Primary Total Hip Arthroplasty?: Experience From Colombia.

BACKGROUND: Anemia is a common condition and a known risk factor for complications after primary total hip arthroplasty. Few studies have evaluated this topic in Latin American countries where this problem can be more important. The purpose of this study was to determine the role of preoperative anemia in 30-day complications after primary total hip arthroplasty. METHODS: This was a retrospective observational study involving patients who had a primary total hip arthroplasty aged more than 18 years and did not have any type of malignancy. Two hundred thirty six patients were divided into 2 groups: 58 who had anemia and 178 who did not have anemia. Multivariate logistic regressions were used to assess the relationship between anemia as a risk factor for blood transfusions, extended lengths of stay, and intensive care unit (ICU) admissions. RESULTS: A higher proportion of patients in the anemia group required blood transfusions (24.1% versus 7.3%, < 0.001), ICU admission (39.7% versus 11.2%, P ≤ .001), and a hospital stay of more than 5 days (37.9% versus 11.8%, < .001). Preoperative anemia was identified as a risk factor for requiring transfusions (Odds ratio 3.82, Confidence Interval 95%: 1.47-9.94, P = .006) and ICU admission (Odds ratio 2.48, Confidence interval 95%: 1.11-5.50, P = .026). CONCLUSION: Preoperative anemia proved to be a risk factor for requiring blood transfusions and ICU admission. Treating this potentially modifiable risk factor can improve patient morbidity and mortality, while positively impacting healthcare costs, reducing the need for postsurgical services such as ICU management, and extended hospitalizations.

Prevalencia de Staphylococcus aureus resistente a meticilina en personal de la unidad de terapia intensiva de la Clínica Universitaria Bolivariana, Medellín 2004 / Prevalence of personnel of the intensive of Medellín 2004

Objetivos. Se determinó la prevalencia de Staphylococcus aureus resistente a meticilina en el personal de la unidad de terapia intensiva de la Clínica Universitaria Bolivariana y la prevalencia de S. aureus en fosas nasales y faringe en la misma población. Metodología. En este estudio descriptivo, se tomaron muestras de fosas nasales y faringe de 45 trabajadores de la unidad de terapia intensiva. Las muestras se sembraron en agar sangre de cordero, a partir del cual se repicaron las colonias de Staphylococcus spp. identificadas por medio de la coloración de Gram y la prueba de catalasa. Mediante la prueba de la coagulasa en tubo y la fermentación del manitol, se confirmaron como S. aureus. A estos aislamientos se les determinó la sensibilidad a antibióticos por el método de Kirby-Bauer. Una vez establecida la resistencia a oxacilina a través del antibiograma, ésta se confirmó con la prueba de tamizaje en Mueller-Hinton con suplemento de oxacilina (6 µg/ml) y NaCl (4%). A los aislamientos SARM confirmados se les realizó el tamizaje de difusión por disco - con cefoxitina- para la predicción de la resistencia a meticilina mediada por el gen mecA. Los datos tabulados en Excel se analizaron en SPSS. Resultados. Laprevalencia de Staphylococcus aureus resistente a meticilina fue de 6,7%. La región anatómica en la que se obtuvo el mayor número de aislamientos correspondióa las fosas nasales.

Objective. Our objective was to determine the prevalence of methicilin resistant Staphylococcus aureus (MRSA) and methicilin sensitive Staphylococcus aureus (MSSA) in the nasal cavity of the personal that labours at the intensive care unit at the Clínica Universitaria Bolivariana. Methodology. In this descriptive study, samples from nasal cavity and pharynx were taken from 45 members of the Intensive Care Unit staff. The samples were seed on plates nurtured with lamb’s blood agar from which we isolated S. aureus colonies that were identified by means of the Gram coloration and the catalase. Coagulase test and manitol fermentation were perfomed in order to confirm S. aureus. The antibiotic sensitivity was determined by the Kirby Bauer method. The oxacillin resistance was confirmed with the Mueller Hinton screening test in oxacillin (6 mg/ml) and NaCl (4%) supplemented media. A diffusion screen test on disk with cefoxitin was performed to MRSA strains to predict whether the methicilin resistance was mediated by the mecA gen. The data was tabulated in Excel and analyzed in SPSS. Results. The prevalence of MRSA was 6.7%. Nasal cavity was the most common anatomical site from which the isolated came.