Risk Factors for Transfusions Following Total Joint Arthroplasty in Patients with Rheumatoid Arthritis

Elizabeth Salt, Amanda T. Wiggins, Mary Kay Rayens, Katelyn Brown, Kate Eckmann, Andrew Johannemann, Raymond D. Wright, Leslie J. Crofford

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background/Objective Despite effective therapies, rheumatoid arthritis (RA) can result in joint destruction requiring total joint arthroplasty to maintain patient function. An estimated 16% to 70% of those undergoing total joint arthroplasty of the hip or knee will receive a blood transfusion. Few studies have described risk factors for blood transfusion following total joint arthroplasty in patients with RA. The aim of this study was to identify demographic and clinical risk factors associated with receiving a blood transfusion following total joint arthroplasty among patients with RA. Methods A retrospective study (n = 3270) was conducted using deidentified patient health claims information from a commercially insured, US data set (2007-2009). Data analysis included descriptive statistics and multivariate logistic regression. Results Females were more likely to receive a blood transfusion (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.16-1.87; p = 0.001). When compared with those in the South, patients residing the Midwest were less likely to receive a blood transfusion following total joint arthroplasty (OR, 0.56; 95% CI, 0.44-0.71). Relative to those receiving total knee arthroplasty, patients who underwent total hip arthroplasty were more likely to receive a blood transfusion (OR, 1.39; 95% CI, 1.14-1.70), and patients who underwent a total shoulder arthroplasty were less likely to receive a blood transfusion (OR, 0.14; 95% CI, 0.05-0.38; p < 0.001). Patients with a history of anemia were more likely to receive a blood transfusion compared with those who did not have this diagnosis (OR, 3.30; 95% CI, 2.62-4.14; p < 0.001). Conclusions Risk factors for the receipt of blood transfusions among RA patients who have undergone total joint arthroplasty were identified.

Original languageEnglish
Pages (from-to)422-426
Number of pages5
JournalJournal of Clinical Rheumatology
Volume24
Issue number8
DOIs
StatePublished - Dec 1 2018

Bibliographical note

Funding Information:
This work was supported in part by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (UL1TR000117). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Access to the large commercially insured data set was made available with funding from CTSA UL1TR000117. E.S. has funding from Pfizer's Medical Education Grants program for an unrelated project.

Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • anemia
  • rheumatoid arthritis
  • risk factors
  • total joint arthroplasty
  • transfusions

ASJC Scopus subject areas

  • Rheumatology

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