Factors associated with an increased risk of postoperative blood transfusions in patients undergoing total hip arthroplasty – A mini-review
Gavin David O'Connor
School of Medicine, University College Cork, Cork, Ireland
Introduction: Elective total hip arthroplasty is a common surgery performed around the world. Many patients undergoing elective total hip arthroplasty are elderly, with a large proportion being anaemic preoperatively. The aim of this mini-review is to discuss the numerous factors associated with blood transfusions after total hip arthroplasty, with particular emphasis on preoperative anaemia.
Methods: This is a mini-review of the literature regarding factors associated with increased rates of postoperative blood transfusions and methods and strategies to reduce the incidence of postoperative blood transfusions after elective total hip arthroplasty.
Results: Preoperative anaemia is a common condition in patients undergoing elective total hip arthroplasty. Preoperative anaemia, age, and increasing ASA score are all associated with increased rates of postoperative blood transfusions.
Conclusion: Preoperative anaemia, increased age and ASA score are all associated statistically with increased rates of postoperative blood transfusions in patients undergoing elective total hip arthroplasty.
DOI: 10.29245/2767-5130/2024/3.1208 View / Download PdfDifferences in Total Hip Arthroplasty Utilization Across Subspecialties and Practice Environments for Geriatric Displaced Femoral Neck Fractures: Secondary Analysis of Bullet Health Analysis (BHA) I
Clary J. Foote1, Chirag Soni2, Shaun P. Patel3, Derek Moore4,5, Jan P Szatkowski2,4*
1McMaster University, Hamilton, Canada
2Department of Orthopedics, Indiana University Health, Indianapolis, USA
3Department of Orthopedics, Southern California Permanente Medical Group, Irvine, USA
4Orthobullets, Santa Barbara, California, USA
5Santa Barbara Orthopedic Associates, Santa Barbara, USA
Purpose: The growing geriatric population has led to a sharp rise in geriatric displaced femoral neck fractures (DFNF). Global reporting is pivotal in deciphering surgeons' decision-making, managing geriatric DFNF. This study aims to further analyze the nuanced utilization preferences and stratifies these across various subspecialities, practice environments, and countries.
Methods: A longitudinal survey from 2020 to 2023 was conducted online via Orthobullets Case Studies, a global orthopaedic collaboration platform, to ascertain treatment preferences for geriatric DFNF. Standardized peer-reviewed polls were used to capture surgeon preferences for total hip arthroplasty (THA). A multivariable regression analysis assessed THA utilization odds across practice environments, subspecialities, and geographic factors, followed by a robust analysis to furnish precise estimates of THA preferences to represent the general population.
Results: Among the 2606 respondents surveyed, 51.5% expressed a preference for THA. Subspecialty preferences were distributed as follows: Arthroplasty (63.4%), Trauma (53.4%), General orthopaedics (51.4%), and Sports (40.2%). Notably, hospitals exhibited a higher inclination towards THA (53.3%) compared to private practices (41.2%) (i.e. one additional THA for every seven fractures managed in a hospital setting). Regression analyses unveiled a significant 3-fold odds difference in THA rates across diverse practice environments and subspecialties. Academic arthroplasty surgeons displayed a 5.4 times higher inclination for THA (i.e. two additional THAs for every five fractures encountered).
Conclusion: Practice environment profoundly influences THA utilization for geriatric DFNF. The study findings underscore the critical need for future trials, advocating for randomized evaluations across subspecialties, geographical regions, and varied practice settings to holistically inform best practices in orthopaedic care.
Level of Evidence
Level III Surgical Practice Survey (Global Practice Trends).
DOI: 10.29245/2767-5130/2024/3.1209 View / Download PdfAwareness of Osteoporosis among Postmenopausal Women in Najran Region, Saudi Arabia: A Cross-Sectional Study
Rashed Salem Alqudhaya1, Saleh Yousef Alyami2*, Salem Mohammed AlHashel2, Hidar Salem Alqudhaya2, Eibraheim Ahmad AlMardef2, Nemer Nasser AlMardef2, Mohammed Nasser AlMutlaq2, Ali Salem AlShaiban2, Ashjan Saeed AlMansour2, Yunus Salem Alyami3
1King Khalid Hospital, Najran city, Saudi Arabia
2College of Medicine, Najran University, Najran City, Saudi Arabia
3Medical Laboratory, Najran University, Najran city, Saudi Arabia
Introduction: Osteoporosis is characterized by a decrease in bone mass. Fractures due to osteoporosis are associated with chronic pain, limited mobility, increased mortality, and financial burdens. While osteoporosis is common in both genders, postmenopausal women are at increased risk. This study aims to evaluate the awareness of osteoporosis among postmenopausal women in the Najran region, Saudi Arabia, and to identify its associated factors.
Methods: This cross-sectional study was conducted from April to June 2024. It evaluated osteoporosis awareness among 313 postmenopausal women in Najran, Saudi Arabia, excluding postmenopausal women who work as healthcare providers on hormone replacement therapy and with mental limitations. An online questionnaire assessed demographic and osteoporosis-related characteristics using the Osteoporosis Knowledge Assessment Tool (OKAT), an Arabic valid and reliable tool, had 20 questions rated on a three-point Likert scale (true, false, and I don’t know).
Results: Out of 701 women, only 313 postmenopausal women were included. The median age was 53 years. Seventy-five percent (236) were married,145 (46%) had a university education or higher and 162 (52%) were housewives. Thirty-six percent (114) and 98 (31%) had a personal and family history of osteoporosis, respectively. The median age at puberty was 13 years, and 226 (72%) reported a history of regular menses previously. The mean knowledge score was 8.965±3.406. Among the participants, 43.5% had good knowledge of osteoporosis. Higher education levels were significantly associated with better knowledge (p=0.030), with those with a university education scoring higher than those with lower education levels.
Conclusion: Although 43.5% of participants demonstrated good knowledge of osteoporosis, the majority had poor knowledge, highlighting a significant gap in awareness that needs to be addressed through targeted educational interventions
DOI: 10.29245/2767-5130/2024/3.1206 View / Download Pdf