Evidence map›Paper›PMID 24553883›Full record

ArticleThe Journal of bone and joint surgery. American volume2014

Impact of perioperative allogeneic and autologous blood transfusion on acute wound infection following total knee and total hip arthroplasty.

Erik T Newman, Tyler Steven Watters, John S Lewis, Jason M Jennings, Samuel S Wellman, David E Attarian, Stuart A Grant, Cynthia L Green, Thomas P Vail, Michael P Bolognesi

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in The Journal of bone and joint surgery. American volume, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03623789 (Blood-saving Effect of Combined Intravenous Tranexamic Acid With Topical Floseal® Application, a Comparison With Intravenous Tranexamic Acid Only in Total Hip Arthroplasty), which is not on this map. Cited by 54 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 7 pooled it
8.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03623789 phase4unknown statusnot on this mapstarted 2018, after this paper: background citation

Blood-saving Effect of Combined Intravenous Tranexamic Acid With Topical Floseal® Application, a Comparison With Intravenous Tranexamic Acid Only in Total Hip Arthroplasty

TypeinterventionalSponsorChang Gung Memorial HospitalRan2018 to 2020Enrolled90ConditionsHip Replacement, TotalArmsintravenous application of tranexamic acid, Floseal hemostatic matrix, Normal saline
3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 7 syntheses or guidelines pooled it, 151 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Erik T NewmanDepartment of Orthopaedic Surgery (E.T.N., T.S.W., J.S.L., J.M.J., S.S.W., D.E.A., and M.P.B.), Anesthesiology (S.A.G.), and Biostatistics and Bioinformatics (C.L.G.), Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tyle.
Tyler Steven WattersDepartment of Orthopaedic Surgery (E.T.N., T.S.W., J.S.L., J.M.J., S.S.W., D.E.A., and M.P.B.), Anesthesiology (S.A.G.), and Biostatistics and Bioinformatics (C.L.G.), Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tyle.
John S LewisDepartment of Orthopaedic Surgery (E.T.N., T.S.W., J.S.L., J.M.J., S.S.W., D.E.A., and M.P.B.), Anesthesiology (S.A.G.), and Biostatistics and Bioinformatics (C.L.G.), Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tyle.
Jason M JenningsDepartment of Orthopaedic Surgery (E.T.N., T.S.W., J.S.L., J.M.J., S.S.W., D.E.A., and M.P.B.), Anesthesiology (S.A.G.), and Biostatistics and Bioinformatics (C.L.G.), Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tyle.
Samuel S WellmanDepartment of Orthopaedic Surgery (E.T.N., T.S.W., J.S.L., J.M.J., S.S.W., D.E.A., and M.P.B.), Anesthesiology (S.A.G.), and Biostatistics and Bioinformatics (C.L.G.), Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tyle.
David E AttarianDepartment of Orthopaedic Surgery (E.T.N., T.S.W., J.S.L., J.M.J., S.S.W., D.E.A., and M.P.B.), Anesthesiology (S.A.G.), and Biostatistics and Bioinformatics (C.L.G.), Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tyle.
Stuart A GrantDepartment of Orthopaedic Surgery (E.T.N., T.S.W., J.S.L., J.M.J., S.S.W., D.E.A., and M.P.B.), Anesthesiology (S.A.G.), and Biostatistics and Bioinformatics (C.L.G.), Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tyle.
Cynthia L GreenDepartment of Orthopaedic Surgery (E.T.N., T.S.W., J.S.L., J.M.J., S.S.W., D.E.A., and M.P.B.), Anesthesiology (S.A.G.), and Biostatistics and Bioinformatics (C.L.G.), Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tyle.
Thomas P VailDepartment of Orthopaedic Surgery, University of California, San Francisco Medical Center, San Francisco, CA 94143.
Michael P BolognesiDepartment of Orthopaedic Surgery (E.T.N., T.S.W., J.S.L., J.M.J., S.S.W., D.E.A., and M.P.B.), Anesthesiology (S.A.G.), and Biostatistics and Bioinformatics (C.L.G.), Duke University Medical Center, Durham, NC 27710. E-mail address for T.S. Watters: tyle.
Duke University · USUniversity of California San Francisco Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients undergoing total hip or knee arthroplasty frequently receive blood transfusions. The relationship between transfusion and the risk of infection following total joint arthroplasty is unclear. In this study, we sought to examine the impact of allogeneic and autologous transfusion on the risk of acute infection following total hip and total knee arthroplasty.

methodsWe performed a retrospective study of consecutive primary total knee arthroplasties and total hip arthroplasties. Patients who had a reoperation for suspected infection within three months after the arthroplasty were identified. Differences in risk factors were assessed across transfusion groups: no transfusion, autologous only, and allogeneic exposure (allogeneic with or without additional autologous transfusion). Backward-stepwise logistic regression analysis was used to compare reoperations (as outcomes) between cases with and those without allogeneic exposure. Prespecified covariates were body mass index, diabetes, an American Society of Anesthesiologists (ASA) score of >2, preoperative hematocrit, and total number of units transfused perioperatively.

resultsWe identified 3352 patients treated with a total hip or knee arthroplasty (1730 total knee arthroplasties and 1622 total hip arthroplasties) for inclusion in the study. Transfusion was given in 1746 cases: 836 of them had allogeneic exposure, and 910 had autologous-only transfusion. There were thirty-two reoperations (0.95%) for suspected infection. Between-group risk-factor differences were observed. The mean age and the rates of diabetes, immunosuppression, ASA scores of >2, and bilateral surgery were highest in the allogeneic group, as were estimated blood loss, surgery duration, and total number of units transfused (p < 0.001). In the unadjusted analyses, the rate of reoperations for suspected infection was higher in the cases with allogeneic exposure (1.67%) than in those without allogeneic exposure (0.72%) (p = 0.013). Autologous-only transfusion was not associated with a higher reoperation rate. However, multivariable logistic regression demonstrated that the total number of units transfused (p = 0.011) and an ASA score of >2 (p = 0.008)-but not allogeneic exposure-were significantly predictive of a reoperation.

conclusionsPerioperative allogeneic transfusion was associated with a higher rate of reoperations for suspected acute infection. However, patients with allogeneic exposure had increased infection risk factors. After adjustment for the total number of units transfused and an ASA score of >2, allogeneic exposure was not significantly predictive of a reoperation for infection.

Indexed as

AgedAged, 80 and overArthroplasty, Replacement, HipArthroplasty, Replacement, KneeBlood TransfusionFemaleHumansMaleMiddle AgedReoperationRetrospective StudiesRisk FactorsSurgical Wound InfectionTreatment Outcome

Identifiers

PMID24553883
OpenAlexW2051300945

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.