中国输血杂志2025，Vol.38Issue(2)：201-208,8.DOI:10.13303/j.cjbt.issn.1004-549x.2025.02.007
美国住院患者全膝关节翻修术围手术期输血的危险因素分析
Risk factors of blood transfusion in total knee revision in the United States
摘要
Abstract
Objective To explore the incidence and risk factors of blood transfusion undergoing total knee revision(TKR)using a nationwide database.Methods A retrospective data analysis was conducted based on the Nationwide Inpa-tient Sample(NIS),enrolling patients who underwent TKR from 2015 to 2019 with complete information.Patients under 18 years old and those using anticoagulants,antiplatelets,antithrombotic and non-steroidal were excluded.The patients were divided into two groups based on whether they received blood transfusion or not.The demographic characteristics,length of stay(LOS),total charge of hospitalization,hospital characteristics,hospital mortality,comorbidities and perioperative com-plications by Wilcoxon rank test for continuous data and chi-square test for categorical data.Logistic regression was per-formed to identify risk factors of blood transfusion undergoing TKR.Results The NIS database included 63 359 patients who underwent TKR.Among them,5 271 patients received blood transfusion,with an incidence of blood transfusion of 7.8%.There was a decrease in the incidence over the years from 2015 to 2019,dropping from 10.2%to 6.5%.TKR pa-tients requiring transfusions had experienced longer LOS,incurred higher total medical expenses,utilized Medicare more frequently,and had increased in-hospital mortality rates(all P<0.001).Independent risk factors for blood transfusion in-cluded female gender,iron-deficiency anemia,rheumatoid disease,collagen vascular disease,chronic blood loss anemia,congestive heart failure,coagulopathy,diabetes with chronic complications,lymphoma,fluid and electrolyte disorders,pe-ripheral vascular disorders,renal failure,valvular disease and weight loss(malnutrition).In addition,risk factors for trans-fusion in TKR surgery included sepsis,acute myocardial infarction,deep vein thrombosis,gastrointestinal bleeding,heart failure,pneumonia,urinary tract infection,acute renal failure,postoperative delirium,wound infection,lower limb nerve injury,hemorrhage,seroma,hematoma,wound rupture and non healing.Conclusion Our findings highlight the impor-tance of recognizing the risk factors of blood transfusion in TKR and establishing corresponding clinical pathways and inter-vention measures to reduce the occurrence of adverse events.关键词
全膝关节翻修术/输血/危险因素/发病率/美国住院患者样本Key words
total knee revision(TKR)/blood transfusion/risk factors/incidence/nationwide inpatient sample分类
医药卫生引用本文复制引用
李笑银,包良笑,谢豪,杨钦烽,高鹏程,王健,史占军..美国住院患者全膝关节翻修术围手术期输血的危险因素分析[J].中国输血杂志,2025,38(2):201-208,8.基金项目
南方医院护理创优循证护理项目(2024EBNc008) （2024EBNc008）
