THE PREDICTORS OF RED-CELL TRANSFUSIONS IN TOTAL HIP ARTHROPLASTIES

Background: Most blood crossmatched in a hospital blood bank is for su rgical patients, and the majority is never transfused. The maximal sta ndard blood order schedule is used to promote efficient ordering pract ices for surgical patients. Study Design and Methods: To ascertain the predictors of red cell transfusions for patients undergoing total hip arthroplasty, the charts of 299 adult patients undergoing primary and revision total hip arthroplasty were reviewed, A surgical blood order equation was developed for calculating the number of units of red cel ls that should be ordered. Stepwise regression analysis was used to de termine which patient- and case-related variables should be considered in the surgical blood order equation,. Results: The significant indic ators for allogeneic red cell transfusion to patients on the day of to tal hip arthroplasty were preoperative hemoglobin concentration, weigh t, age, estimated blood loss, and aspirin use. The surgical blood orde r equation would result in a lower crossmatch-to-transfusion ratio tha n would the maximal standard blood order schedule (1.23 vs. 3.14). Cos ts were also lower with the surgical blood order equation. Conclusion: Incorporation of patient factors resulted in increased efficiency of blood-ordering practices in total hip arthroplasty.