A RETROSPECTIVE AUDIT OF BLOOD-LOSS IN TOTAL HIP-JOINT REPLACEMENT SURGERY AT MIDDLEMORE-HOSPITAL

Aims. To quantify the level of inappropriate red cell transfusion in p rimary and complex hip replacement surgery. Methods. Data extraction w as by retrospective review of patients' records. Calculation of total red cell volume loss was by use of pre and postoperative (day 7) haema tocrit levels, patient weight and number of units transfused, Transfus ion was accepted as justified only if instituted for a 30% red cell vo lume loss or loss sufficient to drop the haematocrit below 0.28. Resul ts. Of 104 patients having primary hip joint replacement, 58 were tran sfused with a total of 157 units of red cells; 37 (24%) of these units were given inappropriately, Of 38 patients having complex hip replace ment operations, 32 were transfused with a total of 139 units of red c ells; 12 (9%) of these were given inappropriately. Conclusions. Inappr opriate transfusion occurs in hip replacement surgery. A concurrent au dit of red cell usage is required to better define the magnitude of th e problem, Two unit transfusion is commonly given when one unit would have been sufficient.