Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe.
Background: Allogenic blood transfusions are expensive and associated with risks and complications such as transmission of infections and incompatibility reactions. Aim: The objective of this study was to evaluate the efficacy of autologous blood transfusion in reducing the need for allogenic blood requirement after total hip replacement and also the cost benefit involved. Method: A retrospective case notes analysis of 178 consecutive patients undergoing total hip replacements from 2006 to 2007 were carried out. 73 patients belonged to Bellovac® ABT (Astra Tech) drains for post-operative blood salvage group (ABT group) and 105 patients belonged to standard Bellovac® (Astra Tech) vacuum drains group (Non-ABT group). Pre and post-operative haemoglobin (Hb) were compared between ABT and Non-ABT group in relation to type of surgery and anaesthesia. Results: 20 out of the 73 (27.3%) patients in ABT group and 45 out of 105 (42.8%) in Non-ABT group required blood transfusion (p=0.035). Forty six units (0.63 units per person) in ABT group and 106 units (1 unit per person) in Non-ABT were transfused in total (p=0.03). The average pre and post-operative Hb in ABT group were 13.1 and 9.6 while in Non-ABT group were 13.4 and 9.4 respectively. Conclusion: Autologous blood transfusion caused a reduction in the number of patients requiring blood transfusion and also reduced the amount of units transfused.