naa a22 4500 510760554 CHVBK 20180411083137.0 cr unu---uuuuu 180411e20130701xx s 000 0 eng 10.1007/s11420-013-9327-y doi (NATIONALLICENCE)springer-10.1007/s11420-013-9327-y Blood Utilization After Primary Total Joint Arthroplasty in a Large Hospital Network [Elektronische Daten] [Antonia Chen, Brian Klatt, Mark Yazer, Jonathan Waters] Background: Since a study in orthopedic hip fracture patients demonstrated that a liberal hemoglobin (Hb) threshold does not improve patient morbidity and mortality relative to a restrictive Hb threshold, the standard of care in total joint arthroplasty (TJA) should be examined to understand the variability of red blood cell (RBC) transfusion following TJA. Questions/purposes: The study aimed to answer the following questions: (1) What is the blood utilization rate after primary TJA for individual surgeons within a large hospital network? (2) What is the comparison of hospital charges, length of stay (LOS), and discharge locations among TJA patients who were and were not transfused? Methods: A retrospective study was conducted on 3,750 primary total knee arthroplasties (TKAs) and 2,070 primary total hip arthroplasties (THAs), and data was retrospectively collected over a 15-month period on the number of RBCs transfused per patient, along with demographic and cost details. The number of patients who received at least 1 RBC unit and the number of RBCs transfused per patient was calculated and stratified by surgeon. Results: In the postoperative period, 19.3% TKA patients and 38.5% THA patients received a RBC transfusion. Transfusion rates following TJA varied widely between surgeons (TKA 4.8-63.8%, THA 4.3-86.8%). Transfused TKA patients received an average of 1.65 ± 0.03 RBCs, and THA patients received an average of 1.97 ± 0.14 RBCs. LOS and hospital charges for blood transfusion patients were higher than nontransfused patients. Conclusion: Blood utilization after primary TJA varies greatly among surgeons, suggesting that resources may be misallocated. These findings highlight the need to standardize RBC transfusion practice following TJA. Hospital for Special Surgery, 2013 total joint arthroplasty nationallicence blood utilization nationallicence transfusion rate nationallicence blood management nationallicence red blood cell (RBC) transfusion nationallicence intervention nationallicence Chen Antonia Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 5230 Centre Avenue, Suite 415, 15232, Pittsburgh, PA, USA aut Klatt Brian Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 5230 Centre Avenue, Suite 415, 15232, Pittsburgh, PA, USA aut Yazer Mark Department of Pathology, University of Pittsburgh Medical Center, 5230 Centre Avenue, Suite 415, 15232, Pittsburgh, PA, USA aut Waters Jonathan Department of Anesthesiology, University of Pittsburgh Medical Center, 300 Halket Street, Suite 3510, 15213, Pittsburgh, PA, USA aut HSS Journal ® Springer US; http://www.springer-ny.com 9/2(2013-07-01), 123-128 1556-3316 9:2<123 2013 9 11420 https://doi.org/10.1007/s11420-013-9327-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11420-013-9327-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chen Antonia Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 5230 Centre Avenue, Suite 415, 15232, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Klatt Brian Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 5230 Centre Avenue, Suite 415, 15232, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Yazer Mark Department of Pathology, University of Pittsburgh Medical Center, 5230 Centre Avenue, Suite 415, 15232, Pittsburgh, PA, USA aut NATIONALLICENCE 700 1- Waters Jonathan Department of Anesthesiology, University of Pittsburgh Medical Center, 300 Halket Street, Suite 3510, 15213, Pittsburgh, PA, USA aut NATIONALLICENCE 773 0- HSS Journal ® Springer US; http://www.springer-ny.com 9/2(2013-07-01), 123-128 1556-3316 9:2<123 2013 9 11420 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer