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Archives of Orthopaedic and Trauma Surgery

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01-03-2018 | Orthopaedic Surgery

Bleeding in primary shoulder arthroplasty

Authors: Dominik Malcherczyk, Asma Abdelmoula, Thomas J. Heyse, Christian D. Peterlein, Brandon Greene, Bilal F. El-Zayat

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2018

Abstract

Introduction

The aim of this investigation was to analyse “total blood loss” (TBL), “blood transfusion rate” (BT) and the “amount of transfused blood units” (BU) between the different primary shoulder arthroplasty (SA) types: reverse, anatomical and stemless. Only primary SA was included. Further goal was to identify risk factors for TBL, amount of BU and BT rate.

Methods

A retrospective charts analysis of patients who received primary SA for degenerative shoulder pathology in our institution between 2004 and 2016 was performed. The demographic data, co-morbidities, haemoglobin and hematocrit level, BT rate, amount of transfused BU etc. were collected. TBL was estimated. Linear regression, log-linear poisson regression and logistic regression were used to compare the outcomes TBL, amount of transfused BU and BT rate, respectively, between different prosthesis types.

Results

Of 278 patients included in this study 209 received reverse, 57 anatomical and 12 stemless SA. Mean TBL was 392.7 ml in reverse, 394.6 ml in anatomical and 298.3 ml in stemless SA. The BT rate and mean amount of BU were, respectively, 14.4% and 0.32 in reverse and 8.77% and 0.23 in anatomical SA. None of the patients with stemless arthroplasty received BT. Significant risk factors for elevated TBL are operation time, higher BMI, male sex. Significant risk parameters for BT and higher amount of transfused BU are low BMI, cemented arthroplasty, coronary heart disease, ASA score > 2 and previous therapy with vitamin K antagonists.

Conclusion

Although there were little differences between the blood transfusion rates in reverse vs. anatomical arthroplasty, there was no difference in total blood loss between these different prosthesis types. None of the patients with stemless arthroplasty received blood transfusion. There are various risk factors affecting total blood loss and blood transfusion rate. However, risk parameters influencing blood transfusion may be different to them affecting total blood loss.

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Title: Bleeding in primary shoulder arthroplasty
Authors: Dominik Malcherczyk
Asma Abdelmoula
Thomas J. Heyse
Christian D. Peterlein
Brandon Greene
Bilal F. El-Zayat
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 3/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2851-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Bleeding in primary shoulder arthroplasty

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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