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Bone Density May Be a Promising Predictor for Blood Loss during Total Hip Arthroplasty

Background: Total hip arthroplasty (THA), which is performed mostly in elderly individuals, can result in substantial blood loss and thereby imposes a significant physical burden and risk of blood transfusion. The femoral neck cut and reamed acetabulum are the main sites of intraoperative bleeding....

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Autores principales: Zhu, Wei, Wei, Zhanqi, Zhou, Tianjun, Han, Chang, Lv, Zehui, Wang, Han, Feng, Bin, Weng, Xisheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325145/
https://www.ncbi.nlm.nih.gov/pubmed/35887715
http://dx.doi.org/10.3390/jcm11143951
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author Zhu, Wei
Wei, Zhanqi
Zhou, Tianjun
Han, Chang
Lv, Zehui
Wang, Han
Feng, Bin
Weng, Xisheng
author_facet Zhu, Wei
Wei, Zhanqi
Zhou, Tianjun
Han, Chang
Lv, Zehui
Wang, Han
Feng, Bin
Weng, Xisheng
author_sort Zhu, Wei
collection PubMed
description Background: Total hip arthroplasty (THA), which is performed mostly in elderly individuals, can result in substantial blood loss and thereby imposes a significant physical burden and risk of blood transfusion. The femoral neck cut and reamed acetabulum are the main sites of intraoperative bleeding. Whether the bone density in that region can be used to predict the amount of blood loss in THA is unknown. Methods: We retrospectively analyzed adult patients undergoing primary THA in the Department of Orthopedics, Peking Union Medical College Hospital, from January 2018 to January 2020. All these patients underwent primary unilateral THA. Patients had their bone mineral density (BMD) recorded within the week before surgery and were stratified and analyzed for perioperative blood loss. Multivariable regressions were utilized to adjust for differences in demographics and comorbidities among groups. Results: A total of 176 patients were included in the study. Intraoperative blood loss was 280.1 ± 119.56 mL. Pearson correlation analysis showed a significant correlation between blood loss and preoperative bone density of both the femoral greater trochanter (R = 0.245, p = 0.001) and the Ward’s triangle (R = 0.181, p = 0.016). Stepwise multiple linear regression showed that preoperative bone density of the greater trochanter (p = 0.015, 95% CI: 0.004–0.049) and sex (p = 0.002) were independent risk factors for THA bleeding. The area under the receiver operating characteristic curve (AUROC) of the greater trochanter and Ward’s triangle was 0.593 (95% CI: 0.507–0.678, p = 0.035) and 0.603 (95% CI: 0.519–0.688, p = 0.018), respectively. The cutoff T value on the femoral greater trochanter for predicting higher bleeding was −1.75. Conclusions: In THA patients, preoperative bone density values of the femoral greater trochanter and sex could be promising independent predictors for bleeding during surgery. Osteoporosis and female patients might have lower blood loss in the THA operation.
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spelling pubmed-93251452022-07-27 Bone Density May Be a Promising Predictor for Blood Loss during Total Hip Arthroplasty Zhu, Wei Wei, Zhanqi Zhou, Tianjun Han, Chang Lv, Zehui Wang, Han Feng, Bin Weng, Xisheng J Clin Med Article Background: Total hip arthroplasty (THA), which is performed mostly in elderly individuals, can result in substantial blood loss and thereby imposes a significant physical burden and risk of blood transfusion. The femoral neck cut and reamed acetabulum are the main sites of intraoperative bleeding. Whether the bone density in that region can be used to predict the amount of blood loss in THA is unknown. Methods: We retrospectively analyzed adult patients undergoing primary THA in the Department of Orthopedics, Peking Union Medical College Hospital, from January 2018 to January 2020. All these patients underwent primary unilateral THA. Patients had their bone mineral density (BMD) recorded within the week before surgery and were stratified and analyzed for perioperative blood loss. Multivariable regressions were utilized to adjust for differences in demographics and comorbidities among groups. Results: A total of 176 patients were included in the study. Intraoperative blood loss was 280.1 ± 119.56 mL. Pearson correlation analysis showed a significant correlation between blood loss and preoperative bone density of both the femoral greater trochanter (R = 0.245, p = 0.001) and the Ward’s triangle (R = 0.181, p = 0.016). Stepwise multiple linear regression showed that preoperative bone density of the greater trochanter (p = 0.015, 95% CI: 0.004–0.049) and sex (p = 0.002) were independent risk factors for THA bleeding. The area under the receiver operating characteristic curve (AUROC) of the greater trochanter and Ward’s triangle was 0.593 (95% CI: 0.507–0.678, p = 0.035) and 0.603 (95% CI: 0.519–0.688, p = 0.018), respectively. The cutoff T value on the femoral greater trochanter for predicting higher bleeding was −1.75. Conclusions: In THA patients, preoperative bone density values of the femoral greater trochanter and sex could be promising independent predictors for bleeding during surgery. Osteoporosis and female patients might have lower blood loss in the THA operation. MDPI 2022-07-07 /pmc/articles/PMC9325145/ /pubmed/35887715 http://dx.doi.org/10.3390/jcm11143951 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zhu, Wei
Wei, Zhanqi
Zhou, Tianjun
Han, Chang
Lv, Zehui
Wang, Han
Feng, Bin
Weng, Xisheng
Bone Density May Be a Promising Predictor for Blood Loss during Total Hip Arthroplasty
title Bone Density May Be a Promising Predictor for Blood Loss during Total Hip Arthroplasty
title_full Bone Density May Be a Promising Predictor for Blood Loss during Total Hip Arthroplasty
title_fullStr Bone Density May Be a Promising Predictor for Blood Loss during Total Hip Arthroplasty
title_full_unstemmed Bone Density May Be a Promising Predictor for Blood Loss during Total Hip Arthroplasty
title_short Bone Density May Be a Promising Predictor for Blood Loss during Total Hip Arthroplasty
title_sort bone density may be a promising predictor for blood loss during total hip arthroplasty
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325145/
https://www.ncbi.nlm.nih.gov/pubmed/35887715
http://dx.doi.org/10.3390/jcm11143951
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