Revision total hip replacement: predictors of blood loss, transfusion requirements, and length of hospitalisation

BACKGROUND: Revision total hip replacement (THR) is associated with increased blood loss and extended hospitalization. MATERIALS AND METHODS: We reviewed 146 patients who underwent revision THR to identify predictors of blood loss, transfusion requirements, and length of hospitalization. RESULTS: Blood loss was greater with increasing age and in men. Femoral and dual-component revision and revision of cemented hip components were also associated with greater blood loss. Transfusion requirements were greater in patients who had lower preoperative hemoglobin concentration and in patients undergoing dual-component revision. Length of hospitalization was significantly increased in patients who received transfusion but less in patients who underwent isolated acetabular-component hip revision. CONCLUSIONS: This study shows significantly greater blood loss in men, older patients, revision surgery of cemented implants, and dual-component revisions. More complex revision surgery and preoperative anemia are clearly associated with increased transfusion requirements and length of hospitalization. Identification and treatment of patients at higher risk of transfusion may guide likely transfusion requirements, shorten the length of hospitalization, and reduce the overall cost of treatment.