| Abstract |
Introduction: As life expectancy extents, the incidence of degenerative osteoarthritis
increases, as well as the number of total hip (THA) and knee arthroplasties (TKA), so
that the patients’ quality of life remains in high levels. But, the fact that this surgery
leads usually to great loss of blood, often demands blood transfusion, which is a
possible risk factor for periprosthetic joint infection.
Aim: The aim of this study is to reveal a possible relevance between blood
transfusion (autologous or heterologous) and the incidence of early SSI, as well as the
assessment of the patient’s preoperative level of quality of life.
Materials and Methods: The sample of the study consists of 56 patients, who were
admitted so as to have a TKA or THA in the department of Orthopedics in University
Hospital of Crete, between January and March 2017. There was documentation of the
blood test results of the patients as well as data about the operation they had pre- and
postoperatively. Also the patients’ quality of life was assessed with the use of the
questionnaires KOOS and HOOS. Finally, a telephone follow-up was made six weeks
postoperatively, so as to be documented the status of the site surgical limb and the
intake of antibiotic prophylaxis.
Results: 66.1% of the sample underwent a TKA and 33.9% a THA. The mean
hospitalisation time of those with TKA was 4.9±1.2 days in contrast of those with
THA which was 5.7±1 days (p=0.024). An autologous transfusion system was used
by the 36.8% of the patients with THA, although by only 16.2% patients with TKA
was used. It was observed that 9.3% of the sample had a high temperature (T≥37.5 ο
C) postoperatively. Also, the mean variation between the preoperative day and the day
of the discharge from the hospital was -21.8% (p<0.001) for hematocrit and -21.2%
(p<0.001) for hemoglobin. Antibiotic prophylaxis was prescribed to 28.6% of the
sample after the hospital discharge (95%CI:17.9-82.1), and the mean duration of the
treatment was 17.0±11.3 days. The most common prescribed drug belonged to the
quinolone category. It seemed also, that the patients who belong to the age group above 65 years had 87% lower risk of antibiotic prophylaxis intake (odds ratio: 0.13,
95%CI:0.03-0.62). There was no important differences between score of KOOS and
HOOS (p<0.05) of the patients who underwent TKA and THA, but generally the
quality of life was poor. Additionally, we need to mention that only 3 patients were
readmitted to the hospital because of inflammation symptoms in the surgical site, but
no infection was confirmed.
Conclusions: The present study indicates that blood transfusion is not a risk factor for
the developement of inflammation symptoms, that lead to the admission of antibiotic
prophylaxis, while the age below 65 years as well as the preoperative low level of
quality of life seems to be. After TKA and THA the admission of antibiotic
prorhylaxis seems to be empirical by inflammation symptoms. Further research is
needed so that can be determined the early symptoms of SSI and periprosthetic joint
infection after TKA and THA, and their association with blood transfusion and the
mental health of the patients.
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Η μετάγγιση αίματος ως παράγοντας κινδύνου για χειρουργικές λοιμώξεις (SSI) μετά από ολική αρθροπλαστική γόνατος και ισχίου και η ποιότητα ζωής των ασθενών αυτών προεγχειρητικά
