Preoperative anemia may increase risk of DVT formation before TJA

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-01-31T09:45:21+05:30 | Updated On 31 Jan 2023 2:53 PM IST

China: Researchers from China found that preoperative anemia screening is necessary to identify preoperative deep vein thrombosis and perioperative blood transfusion in patients undergoing total joint arthroplasty.

The trial results were published in the Journal of Orthopedic Surgery and Research.

Total joint arthroplasty (TJA) includes total hip and total knee arthroplasty (THA and TKA) and is one of the frequently performed procedures for osteoarthritis of the hip and knee. It is mostly associated with the complication of venous thromboembolism. Most of the patients who are undergoing TJA are anemic. Previous data have suggested that anemia is one of the risk factors in TJA but there were not many studies that identified any correlation between preoperative anemia and preoperative deep vein thrombosis development. Hence Xiaojuan Xiong et al conducted a trial to explore the correlation of the severity of preoperative anemia with deep vein thrombosis (DVT) in patients undergoing total joint arthroplasty (TJA).

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Between January 1, 2017, and December 31, 2021, nearly 2461 TJA patients were enrolled. They were classified into anemia and non-anemia groups based on preoperative Hb results and also DVT and non-DVT groups based on preoperative deep vein color ultrasound screening. Propensity score matching (PSM) analysis was used to establish a logistic regression model. Preoperative anemia of TJA patients was used as a dependent variable and DVT-related variables as covariates. The anemia and non-anemia groups were matched based on the ratio of 1:1 (835 pairs) using 0.01 as the caliper value. Binary logistic regression analysis was used to determine the correlation between anemia and the severity of anemia before TJA and DVT.

Findings from the study:

In the total number of participants, preoperative anemia was observed in 872 cases (35.43%) and DVT in 170 cases (6.91%).
The DVT risk of patients with preoperative, moderate, and severe anemia increased by 1.82, 2.77, and 8.26 times, respectively as per the binary logistic regression analysis after PSM.
The risks of blood transfusion in the perioperative period in patients with anemia, mild anemia, moderate anemia, and severe anemia increased by 3.52 times, 2.13, 7.22, and 61.37 times, respectively.

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Thus, Preoperative anemia increased the risk of DVT formation before TJA reiterating the necessity of screening for DVT before TJA. Also, they added that preoperative anemia is an independent risk factor for preoperative DVT and blood transfusion in the perioperative period for TJA patients.

Further reading: Xiong, X., Xu, S., Li, T. et al. Correlation of the severity of anemia in patients undergoing total joint arthroplasty with preoperative deep vein thrombosis: a retrospective cohort study. J Orthop Surg Res 17, 554 (2022). https://doi.org/10.1186/s13018-022-03457-y

OrthopedicsOrthopedic surgeryJournal of Orthopaedic Surgery and ResearchXiaojuan XiongTotal joint arthroplastyjoint surgeryClinical Trial

Source : Journal of Orthopaedic Surgery and Research volume

Dr.Niharika Harsha B

BDS, MDS

Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751