Retrospective study on transfusion strategies and red blood cell transfusion thresholds in orthopedic surgery
10.13303/j.cjbt.issn.1004-549x.2026.07.009
- VernacularTitle:骨科输血策略及红细胞输注阈值的回顾性研究
- Author:
Zijuan LIU
1
;
Liu HE
2
;
Yuwei HU
2
;
Yunhong YU
3
;
Ling LI
1
Author Information
1. School of Public Health, Anhui Medical University, Hefei 230000, China; Department of Blood Transfusion, The Third People’s Hospital of Chengdu, Chengdu 610031, China
2. Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College, Chengdu 610052, China; Key Laboratory of Adverse Transfusion Reactions, Chinese Academy of Medical Sciences, Chengdu 610052, China
3. Department of Blood Transfusion, The Third People’s Hospital of Chengdu, Chengdu 610031, China
- Publication Type:Journal Article
- Keywords:
orthopedic surgery;
perioperative transfusion;
restrictive transfusion;
red blood cell transfusion threshold
- From:
Chinese Journal of Blood Transfusion
2026;39(7):874-880
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the clinical value of a restrictive red blood cell transfusion strategy in orthopedic patients by retrospectively analyzing the current transfusion practices and comparing postoperative outcomes across different transfusion thresholds. Methods: Clinical data of patients who underwent orthopedic surgery and received blood transfusions at a single hospital from 2015 to 2020 were retrospectively collected for descriptive analysis. Patients were then stratified into two groups based on pre-transfusion hemoglobin (Hb) thresholds:70-79 g/L group (n=92) and 80-89 g/L group (n=120), and their data were compared in terms of postoperative hematological parameters, functional recovery, transfusion volume, and adverse events. Results: Among patients receiving orthopedic surgery and transfusion, elderly females accounted for a relatively high proportion. Transfusion requirements varied significantly across different surgical types, with marked differences in red blood cell transfusion volumes (P<0.001). Revision arthroplasty and spinal surgery had higher median volumes (3.5-3.0 U). Subgroup analysis revealed that the 70-79 g/L group had significantly higher postoperative D-dimer and creatinine levels than the 80-89 g/L group (Z=-2.035, P=0.042; Z=-2.523, P=0.012). The pre-transfusion pain score was also significantly higher in the 70-79 g/L group (Z=-2.828, P=0.005), but no significant difference was observed in post-transfusion pain scores between the two groups (P>0.05). Conclusion: This study did not observe significant differences in postoperative adverse events, functional recovery, or transfusion volume-related indicators between the two transfusion thresholds. These findings provide clinical reference data for future studies on the safety and applicability of restrictive transfusion strategies in the orthopedic perioperative setting.
