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Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial

BACKGROUND: Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision sur...

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Autores principales: Nielsen, Kamilla, Johansson, Pär I, Dahl, Benny, Wagner, Michael, Frausing, Britt, Børglum, Jens, Jensen, Kenneth, Stürup, Jens, Hvolris, Jesper, Rasmussen, Lars S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4203913/
https://www.ncbi.nlm.nih.gov/pubmed/25337035
http://dx.doi.org/10.1186/1471-2253-14-89
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author Nielsen, Kamilla
Johansson, Pär I
Dahl, Benny
Wagner, Michael
Frausing, Britt
Børglum, Jens
Jensen, Kenneth
Stürup, Jens
Hvolris, Jesper
Rasmussen, Lars S
author_facet Nielsen, Kamilla
Johansson, Pär I
Dahl, Benny
Wagner, Michael
Frausing, Britt
Børglum, Jens
Jensen, Kenneth
Stürup, Jens
Hvolris, Jesper
Rasmussen, Lars S
author_sort Nielsen, Kamilla
collection PubMed
description BACKGROUND: Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision surgery. METHODS: The trial was registered at Clinicaltrials.gov ( NCT00906295). Sixty-six patients aged 18 years or older undergoing hip revision surgery were randomized to receive RBC at a Hb threshold of either 7.3 g/dL (restrictive group) or 8.9 g/dL (liberal group). Postoperative ambulation was assessed using Timed Up and Go-test (TUG) and ability to walk was also assessed daily by a physiotherapist blinded to the allocation. RESULTS: Fifty-three patients were able to perform the TUG and included in the analysis. The TUG could be completed in a median of 36 sec vs. 30 sec in the restrictive group and the liberal group, respectively (P = 0.02). The mean difference in TUG was 14.5 sec (95% CI 2.8-26.2 sec). No difference was found in the day patients could perform TUG or walk 10 meters. The Hb at the day of testing was 10.2 g/dL in the restrictive group and 9.9 g/dL in the liberal group. Only 26 patients received RBC. CONCLUSIONS: A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing.
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spelling pubmed-42039132014-10-22 Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial Nielsen, Kamilla Johansson, Pär I Dahl, Benny Wagner, Michael Frausing, Britt Børglum, Jens Jensen, Kenneth Stürup, Jens Hvolris, Jesper Rasmussen, Lars S BMC Anesthesiol Research Article BACKGROUND: Transfusion with red blood cells (RBC) may be needed during hip revision surgery but the appropriate haemoglobin concentration (Hb) threshold for transfusion has not been well established. We hypothesized that a higher transfusion threshold would improve ambulation after hip revision surgery. METHODS: The trial was registered at Clinicaltrials.gov ( NCT00906295). Sixty-six patients aged 18 years or older undergoing hip revision surgery were randomized to receive RBC at a Hb threshold of either 7.3 g/dL (restrictive group) or 8.9 g/dL (liberal group). Postoperative ambulation was assessed using Timed Up and Go-test (TUG) and ability to walk was also assessed daily by a physiotherapist blinded to the allocation. RESULTS: Fifty-three patients were able to perform the TUG and included in the analysis. The TUG could be completed in a median of 36 sec vs. 30 sec in the restrictive group and the liberal group, respectively (P = 0.02). The mean difference in TUG was 14.5 sec (95% CI 2.8-26.2 sec). No difference was found in the day patients could perform TUG or walk 10 meters. The Hb at the day of testing was 10.2 g/dL in the restrictive group and 9.9 g/dL in the liberal group. Only 26 patients received RBC. CONCLUSIONS: A Hb transfusion threshold of 8.9 g/dL was associated with a statistically significantly faster TUG after hip revision surgery compared to a threshold of 7.3 g/dL but the clinical importance is questionable and the groups did not differ in Hb at the time of testing. BioMed Central 2014-10-10 /pmc/articles/PMC4203913/ /pubmed/25337035 http://dx.doi.org/10.1186/1471-2253-14-89 Text en © Nielsen et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Nielsen, Kamilla
Johansson, Pär I
Dahl, Benny
Wagner, Michael
Frausing, Britt
Børglum, Jens
Jensen, Kenneth
Stürup, Jens
Hvolris, Jesper
Rasmussen, Lars S
Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial
title Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial
title_full Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial
title_fullStr Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial
title_full_unstemmed Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial
title_short Perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial
title_sort perioperative transfusion threshold and ambulation after hip revision surgery – a randomized trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4203913/
https://www.ncbi.nlm.nih.gov/pubmed/25337035
http://dx.doi.org/10.1186/1471-2253-14-89
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