Estimated Blood Loss, Factors Associated With Blood Loss and Transfusion Rate in Patient under Going Primary Total Hip Replacement at Muhimbili Orthopaedics Institute

Abstract

Primary total hip arthroplasty is a highly effective surgical procedure that was performed in elderly and young patients. Total hip replacement (THR) relieves pain and functional disability experienced by patients with moderate to severe arthritis of the hip and improving their quality of life. Prolong surgical time, medication(TXA) and longer inscion were associated with substantial blood loss which leads to blood transfusion to most of the patients, most of the literature report more than 50% of the patients are transfused during primary THR, in a study done in Lagos among 41 patients, 37(90.2%) receive blood transfusion, there were two ways of estimating blood loss, direct methods was commonly used while the hidden blood loss which was detected by indirect method rarely considered. Objectives: the purpose of this study was to determine estimated Blood loss, factors associated with blood loss and transfusion rate in patient undergoing primary THR at MOI. Methodology: A prospective cross-section study was done at Muhimbili orthopedics institute from April 2020 to April 2021. Patients undergoing THR were recruited into the study using convenience sampling. A questionnaire was administered to capture their demographic data. Follow-up of the respondents was made to check preoperative and post-operative hemoglobin level and utilization of blood during the course of treatment. Duration of surgery, position of the patients, and size of inscion were considered. The data were analyzed using SPSS version 23, the chi-square test was used in discrete variable and t-test in the case of continuous variables, in all cases, an alpha of 0.005 will be adopted for statistical significance. Result: Total of 68 participants undergoing primary THR were included in this study, majority of the participants were male 38(55.88%), aged 60 years and above. The mean estimated blood loss was 1494 mls of blood). There was a 54.8% transfusion rate among the respondent and more than 2hours was associated with more blood loss. vi Conclusion: There is significant blood loss in patients undergoing THR at MOI, which required most of the patients to receive blood transfusion. Longer operating time and lateral positioning were associated with increased blood loss. Recommendations. There is a need for long prospective study on blood loss, factors associated with blood loss and transfusion rate after primary THR, which preclude the descion when to consider for surgical intervations.