Blood Usage Among Orthopedic Patients at the Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Overview

Journal Niger Med J

Date 2025 Jan 29

PMID 39877512

Authors

Friday Enwumelu Aaron

Rex Friday Ogoronte Alderton Ijah

Hannah E Omunakwe

Mike T Achor

Affiliations

Soon will be listed here.

Abstract

Background: Blood transfusion holds a significant place in the practice of surgery, including orthopaedic surgeries. The aim of this study was to evaluate the intraoperative use of blood and blood products among orthopaedic patients operated at the Rivers State University Teaching Hospital from January 2021 to December 2021, focusing on the demographics of patients, number and type of surgeries needing a blood transfusion, and the number of blood transfusions.

Methodology: A retrospective observational study was carried out at the operating theatre of a referral tertiary hospital using a designed proforma to extract data from the registers of operated orthopaedic patients.

Results: There were 168 males and 145 females who were operated on, and 43 (13.74%) of them had intra-operative blood transfusion. Patients between 41 to 50years and 51 to 60 years dominated the distribution with a total of 20 (46.5%), out of 59 blood transfusions carried out. The surgical condition requiring the highest number of blood transfusions was fractures (29), followed by foot gangrene (17) occasioned by diabetes mellitus and peripheral vascular disease. Open reduction and internal fixation for fractures (18) constituted the highest single type of surgery carried out within the study period.

Conclusion: A bimodal age distribution was observed in intraoperative blood transfusion requirements. The orthopaedic intraoperative blood transfusion burden was 13.74%, mainly for open reduction and internal fixation for fractures.

References

Watts C, Pagnano M . Minimising blood loss and transfusion in contemporary hip and knee arthroplasty. J Bone Joint Surg Br. 2012; 94(11 Suppl A):8-10. DOI: 10.1302/0301-620X.94B11.30618. View

Jiang J, Zhou R, Li B, Xue F . Is deliberate hypotension a safe technique for orthopedic surgery?: a systematic review and meta-analysis of parallel randomized controlled trials. J Orthop Surg Res. 2019; 14(1):409. PMC: 6889611. DOI: 10.1186/s13018-019-1473-6. View

Toy P, KAPLAN E, McVay P, Lee S, Strauss R, Stehling L . Blood loss and replacement in total hip arthroplasty: a multicenter study. The Preoperative Autologous Blood Donation Study Group. Transfusion. 1992; 32(1):63-7. DOI: 10.1046/j.1537-2995.1992.32192116435.x. View

Vaglio S, Prisco D, Biancofiore G, Rafanelli D, Antonioli P, Lisanti M . Recommendations for the implementation of a Patient Blood Management programme. Application to elective major orthopaedic surgery in adults. Blood Transfus. 2015; 14(1):23-65. PMC: 4731340. DOI: 10.2450/2015.0172-15. View

Stoicea N, Bergese S, Ackermann W, Moran K, Hamilton C, Joseph N . Current status of blood transfusion and antifibrinolytic therapy in orthopedic surgeries. Front Surg. 2015; 2:3. PMC: 4325662. DOI: 10.3389/fsurg.2015.00003. View

Singelenberg R . The blood transfusion taboo of Jehovah's Witnesses: origin, development and function of a controversial doctrine. Soc Sci Med. 1990; 31(4):515-23. DOI: 10.1016/0277-9536(90)90048-w. View

Lemos M, Healy W . Blood transfusion in orthopaedic operations. J Bone Joint Surg Am. 1996; 78(8):1260-70. DOI: 10.2106/00004623-199608000-00019. View

Raykar N, Raguveer V, Abdella Y, Ali-Awadh A, Arora H, Asamoah-Akuoko L . Innovative blood transfusion strategies to address global blood deserts: a consensus statement from the Blood Delivery via Emerging Strategies for Emergency Remote Transfusion (Blood DESERT) Coalition. Lancet Glob Health. 2024; 12(3):e522-e529. PMC: 10882207. DOI: 10.1016/S2214-109X(23)00564-8. View

Blankstein A, Houston B, Fergusson D, Houston D, Rimmer E, Bohm E . Transfusion in orthopaedic surgery : a retrospective multicentre cohort study. Bone Jt Open. 2021; 2(10):850-857. PMC: 8558454. DOI: 10.1302/2633-1462.210.BJO-2021-0077.R1. View

10.

Hofmann A, Farmer S, Shander A . Five drivers shifting the paradigm from product-focused transfusion practice to patient blood management. Oncologist. 2011; 16 Suppl 3:3-11. DOI: 10.1634/theoncologist.2011-S3-3. View

11.

Haghpanah S, Miladi S, Kasraian L, Zamani A, Gholami M . Blood Transfusion Practice in Operating Rooms in Nemazee Hospital in Southern Iran. Arch Iran Med. 2021; 24(2):107-112. DOI: 10.34172/aim.2021.16. View

12.

Sambandam B, Batra S, Gupta R, Agrawal N . Blood conservation strategies in orthopedic surgeries: A review. J Clin Orthop Trauma. 2015; 4(4):164-70. PMC: 3880946. DOI: 10.1016/j.jcot.2013.11.002. View

13.

Vrielink H, Smid W . Blood transfusion systems in various middle income countries over the world. Transfus Apher Sci. 2023; 62(5):103796. DOI: 10.1016/j.transci.2023.103796. View

14.

Barro L, Drew V, Poda G, Tagny C, El-Ekiaby M, Owusu-Ofori S . Blood transfusion in sub-Saharan Africa: understanding the missing gap and responding to present and future challenges. Vox Sang. 2018; 113(8):726-736. DOI: 10.1111/vox.12705. View

15.

Diaku-Akinwumi I, Abubakar S, Adegoke S, Adeleke S, Adewoye O, Adeyemo T . Blood transfusion services for patients with sickle cell disease in Nigeria. Int Health. 2016; 8(5):330-5. DOI: 10.1093/inthealth/ihw014. View

16.

Roberts N, James S, Delaney M, Fitzmaurice C . The global need and availability of blood products: a modelling study. Lancet Haematol. 2019; 6(12):e606-e615. DOI: 10.1016/S2352-3026(19)30200-5. View

17.

Hasan O, Khan E, Ali M, Sheikh S, Fatima A, Rashid H . "It's a precious gift, not to waste": is routine cross matching necessary in orthopedics surgery? Retrospective study of 699 patients in 9 different procedures. BMC Health Serv Res. 2018; 18(1):804. PMC: 6195984. DOI: 10.1186/s12913-018-3613-9. View

18.

Feyisa T, Kiya G, Adissu Maleko W . Assessment of recipients' characteristics, transfusion appropriateness, and utilization pattern of blood and blood products in Jimma Medical Center, Jimma, Ethiopia. PLoS One. 2021; 16(4):e0250623. PMC: 8075257. DOI: 10.1371/journal.pone.0250623. View

19.

Theusinger O, Kind S, Seifert B, Borgeat L, Gerber C, Spahn D . Patient blood management in orthopaedic surgery: a four-year follow-up of transfusion requirements and blood loss from 2008 to 2011 at the Balgrist University Hospital in Zurich, Switzerland. Blood Transfus. 2014; 12(2):195-203. PMC: 4039701. DOI: 10.2450/2014.0306-13. View

20.

Sarteschi L . Jehovah's witnesses, blood transfusions and transplantations. Transplant Proc. 2004; 36(3):499-501. DOI: 10.1016/j.transproceed.2004.02.013. View