iron deficiency and/or anaemia before Preop Hb 135.5, 135 138, 138 surgery. mean, (96-180) (92-171) median, Given that this population accounts for (range) significant blood usage, we wanted to Preop 41 (13.2%) 27 (9.2%) investigate the prevalence of anaemia, preoperative anaemia, the use of n (%) blood products and any association Received 25 (8.1%) 10 (3.4%) with outcome. n (%) A total of 603 cases were reviewed, of which 68 patients (11.3%) were Methods anaemic. Thirty-five patients (5.8%) were transfused a combined total of 80 Data were collected retrospectively for units of red cells. all elective hip and joint replacements during 2015. Demographics, operation Preoperative anaemia (Hb <120) was details, length of stay, pre- and present in 13.2% of elective hip and haemoglobin (Hb) and 9.2% of elective knee replacements. details of any transfusion were Preoperative anaemia was associated recorded. with longer inpatient stay particularly – in ASA3 patients, mean length of For the purposes of this project stay was increased from 5.8 days to anaemia was defined as haemoglobin 10.6 days if preoperative anaemia was of less than 120 g/l. present. Results Joint replacement surgery was found to consistently drop haemoglobin by Hip Knee ~20 g/l from baseline. Two thirds of patients who received (n=310) (n=293) blood transfusion were anaemic Female, n 179 (58%) 164 (56%) preoperatively. (%) Conclusion/next steps Age 67.5, 69 69, 69 mean, (31-90) This project quantified the rate of red median, cell transfusion in this purely elective (range) of patients to be 5.8%, with an ASA 1-2, 239 229 (83%) estimated cost of over £13,000 per n (%) (83.5%) year4 and potential for morbidity from ASA 3-4, 47 (16.3%) 46 (16.6%) transfusion. It was interesting to note n (%) that the majority of patients who
iron deficiency and/or anaemia before surgery. Given that this population accounts for significant blood usage, we wanted to investigate the prevalence of preoperative anaemia, the use of blood products and any association with outcome. Methods Data were collected retrospectively for all elective hip and joint replacements during 2015. Demographics, operation details, length of stay, pre- and haemoglobin (Hb) and details of any transfusion were recorded. For the purposes of this project anaemia was defined as haemoglobin of less than 120 g/l. Results Hip (n=310) Knee (n=293) Female, n (%) 179 (58%) 164 (56%) Age mean, median, (range) 67.5, 69 (31-90) 69, 69 ASA 1-2, n (%) 239 (83.5%) 229 (83%) ASA 3-4, n (%) 47 (16.3%) 46 (16.6%) Preop Hb mean, median, (range) 135.5, 135 (96-180) 138, 138 (92-171) Preop anaemia, n (%) 41 (13.2%) 27 (9.2%) Received n (%) 25 (8.1%) 10 (3.4%) A total of 603 cases were reviewed, of which 68 patients (11.3%) were anaemic. Thirty-five patients (5.8%) were transfused a combined total of 80 units of red cells. Preoperative anaemia (Hb <120) was present in 13.2% of elective hip and 9.2% of elective knee replacements. Preoperative anaemia was associated with longer inpatient stay – particularly in ASA3 patients, mean length of stay was increased from 5.8 days to 10.6 days if preoperative anaemia was present. Joint replacement surgery was found to consistently drop haemoglobin by ~20 g/l from baseline. Two thirds of patients who received blood transfusion were anaemic preoperatively. Conclusion/next steps This project quantified the rate of red cell transfusion in this purely elective of patients to be 5.8%, with an estimated cost of over £13,000 per year4 and potential for morbidity from transfusion. It was interesting to note that the majority of patients who
ssa-annals-2018.docx