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Peters YG, Bird A, Bellairs GR, et al. A clinical audit of the utilisation of red cell products in elective total hip replacement surgery. S Afr Med J. 2016;106(8):824-8doi: 10.7196/SAMJ.2016.v106i8.10566.
Peters, Y. G., Bird, A., Bellairs, G. R., & Davison, G. M. (2016). A clinical audit of the utilisation of red cell products in elective total hip replacement surgery. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 106(8), 824-8. https://doi.org/10.7196/SAMJ.2016.v106i8.10566
Peters, Yvonne Grace, et al. "A clinical audit of the utilisation of red cell products in elective total hip replacement surgery." South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde vol. 106,8 (2016): 824-8. doi: https://doi.org/10.7196/SAMJ.2016.v106i8.10566
Peters YG, Bird A, Bellairs GR, Davison GM. A clinical audit of the utilisation of red cell products in elective total hip replacement surgery. S Afr Med J. 2016 Jul 11;106(8):824-8. doi: 10.7196/SAMJ.2016.v106i8.10566. PMID: 27499414.
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S Afr Med J. 2016 Jul 11;106(8):824-8. doi: 10.7196/SAMJ.2016.v106i8.10566.

A clinical audit of the utilisation of red cell products in elective total hip replacement surgery.

South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde

Yvonne Grace Peters, Arthur Bird, Greg R M Bellairs, Glenda Mary Davison

Affiliations

  1. Western Province Blood Transfusion Service, Pinelands, Cape Town, South Africa; Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, Cape Town, South Africa. [email protected].

PMID: 27499414 DOI: 10.7196/SAMJ.2016.v106i8.10566

Abstract

BACKGROUND: Previous studies have documented a marked variation in transfusion practice for total hip replacement (THR) surgery.

OBJECTIVE: To audit red cell product utilisation for THR at two Western Cape tertiary referral hospitals (HY and HG).

METHODS: The folders of 207 consecutive patients undergoing elective THR surgery from January 2013 to December 2013 were reviewed. Information relating to age, sex, clinical observations, indications for surgery, pre- and postoperative haemoglobin (Hb) values, comorbidities, length of hospital stay and transfusion history was recorded.

RESULTS: The transfusion rate at HY (41.6%) was significantly higher than that at HG (10.0%). The mean postoperative Hb in the transfused patients at HG was 8.3 g/dL v. 9.1 g/dL at HY. Females had a significantly higher transfusion rate (33.0%) than males (15.0%) (p<0.05), and the mean age of transfused patients was significantly greater than that of untransfused patients (p<0.005). Although patients with comorbidities had a higher transfusion rate than those without, this did not reach statistical significance. Of 120 patients with complete data, 113 (94.2%) had a blood bank order, of which the vast majority, 102/113 (90.3%), were group-and-screen (G&S) requests; 29/113 (25.7%) were converted to a full crossmatch.

CONCLUSIONS: Overall, the transfusion rate for both hospitals was 25.8%, which is well within published rates. A guideline Hb trigger of 8.0 g/dL is recommended as per published guidelines, with the caveat that the clinical judgement of the attending clinician whether a transfusion is indicated is paramount. Causes of preoperative anaemia should be investigated and treated. Routine cross-matching preoperatively is unnecessary, and a G&S order is sufficient.

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