A retrospective review of patients undergoing primary unilateral TJA between 2015 and 2020 was performed. The primary outcome was whether a specific cutoff delta Hgb was predictive of readmission within 90 days due to anemia-related causes. Secondary outcomes included the presence of acute postoperative anemia and transfusion during readmission.
Six thousand seven hundred and ninety one patients had a median delta Hgb of 2.80. In total, 268 patients (3.95%) were readmitted within 90 days postoperatively, with two patients requiring transfusion during readmission. A significantly higher rate of readmission was found in patients with cardiovascular disease (5.16% versus 3.68%; P = .020). When constructing receiver operating characteristic curves, a cutoff value of 3.20 resulted in an area under curve of 0.595 (0.486-0.704). In patients with cardiovascular disease, a cutoff value of 3.10 resulted in an area under curve of 0.626 (0.466-0.787).
The magnitude of Hgb change was not predictive of anemia-related readmission within 90 days in patients who did not receive a perioperative transfusion. Patients experiencing higher delta Hgb values but remaining above the transfusion threshold may have a greater physiologic reserve.
对2015年至2020年接受原发性单侧TJA的患者进行了回顾性回顾。主要结果是特定的截断值δHgb是否可以预测90天内由于贫血相关原因而再次入院。次要结果包括急性术后贫血和再入院期间输血。
六千七百九十一名患者的中位Hgb为2.80。总的来说,268例患者(3.95%)在术后90天内再次入院,两名患者在再次入院期间需要输血。心血管疾病患者的再入院率明显较高(5.16%vs3.68%;P=0.020)。当构建接收器工作特性曲线时,截止值3.20导致曲线下面积为0.595(0.486-0.704).在心血管疾病患者中,截止值3.10导致曲线下面积为0.626(0.466-0.787).
在未接受围手术期输血的患者中,Hgb变化的幅度不能预测90天内贫血相关的再入院。经历较高的δHgb值但仍高于输血阈值的患者可能具有更大的生理储备。