Journal
ARCHIVES OF GERONTOLOGY AND GERIATRICS
Volume 59, Issue 1, Pages 181-185Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.archger.2014.03.009
Keywords
Postoperative cognitive delirium; Restrictive transfusion; Liberal transfusion; Inflammatory response
Categories
Funding
- National Natural Science Foundation of China [81300946]
- Natural Science Foundation of Jiangsu Province [BK2012778]
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Few studies have examined the association between perioperative blood transfusion and postoperative delirium (POD) in aged patients undergoing total hip replacement surgery. In this prospective study, 186 patients older than 65 years undergoing elective unilateral total hip replacement surgery were enrolled. Of those, 94 patients were randomly assigned to the restrictive strategy transfusion strategy group, in which red blood cells were transfused in order to maintain 10.0 g/dL > hemoglobin >= 8.0 g/dL. Ninety-two patients were randomly assigned to the liberal transfusion strategy group, in which red blood cells were transfused in order to maintain hemoglobin >= 10.0 g/dL. POD was diagnosed by confusion assessment method. The baseline characteristics of patients, the length of hospital stay, the incidence of POD, myocardial infarction, stroke, wound infection, pulmonary embolism, and the transfusion volume were recorded. No difference was observed in the baseline characteristics, the length of hospital stay, and the incidence of POD, myocardial infarction, stroke, wound infection, and pulmonary embolism between the two groups (P > 0.05). The proportion of patients transfused with red blood cell and frozen plasma was decreased in the restrictive transfusion group compared with the liberal transfusion group (P < 0.05). In conclusion, restrictive transfusion does not influence the incidence of POD but reduces blood transfusion. Thus, restrictive transfusion may serve as an effective and safe strategy for aged patients following total hip replacement. (C) 2014 Published by Elsevier Ireland Ltd.
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