The impact of preoperative anemia on red blood cell transfusion in primary and revision hip arthroplasty: A retrospective analysis
Bibliographic record
Abstract
Rationale: Lower extremity joint arthroplasty can lead to significant blood loss, and the need for blood transfusion. The use of blood products is associated with a variety of adverse outcomes including infection, circulatory overload, and transfusion reaction. Objectives: The objective of this quality improvement study is to identify the prevalence of preoperative anemia at our institution, and elucidate its impact on perioperative transfusion in elective patients undergoing primary or revision hip arthroplasty. Methods: Data for this study was collected from four databases at our institution. Elective patients undergoing primary or revision hip arthroplasty were selected. Transfusion was defined as the receipt of a red blood cell transfusion on the surgical day through to postoperative day five. The primary outcome was the effect of preoperative anemia on transfusion rates. Results: The overall transfusion rate was 7.6%. Transfusion rates for primary and revision arthroplasty were 5.8% and 18.7% respectively. Patients with a preoperative hemoglobin between 100 and 120 g/L were 4.5 times more likely to be transfused than those with a hemoglobin between 121 and 140 g/L, and 15.4 times more likely than those greater than 140 g/L. Preoperative anemia was common, with 11.5% of all patients having a preoperative hemoglobin of 120 g/L or less. Conclusion: Preoperative anemia was common and was significantly associated with higher transfusion rates. These findings reinforce the need to optimize hip arthroplasty patients prior to surgery, where possible. As a quality control study, these findings may help direct policy regarding the deferral of elective hip arthroplasty patients who are anemic preoperatively.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".