Transfusion therapy in elective total hip arthroplasty

A retrospective audit of transfusion practice in 150 consecutive elective primary total hip arthroplasties was undertaken, to examine blood usage and to determine the potential for reduction in its use. Predetermined criteria were used to measure unnecessary transfusions. Transfusion was considered unnecessary if the discharge haematocrit exceeded 36%, or if patients who lost less than 30% of their estimated blood volume, were transfused. Using these criteria, overtransfusion occurred in 42-45% patients. The intra-operative blood transfused correlated well with intra-operative blood lost. All other variables showed no significant correlation with both intra-operative and post-operative blood transfused. Females lost less and were transfused significantly more than males. The study corroborates previous reports of blood overuse. These results suggest that adopting standards of practice to measure and to monitor transfusion practice (quality assurance programmes) would be a worthwhile objective.