Independent Risk Factors for Transfusion in Contemporary Revision Total Hip Arthroplasty

Abstract Introduction The incidence of transfusion in contemporary revision total hip arthroplasty (THA) remains high despite recent advances in blood management, including the use of tranexamic acid (TXA). The purpose of this prospective investigation was to determine independent risk factors for transfusion in revision THA. Methods Six centers prospectively collected data on 175 revision THAs. A multivariable logistic analysis was performed to determine independent risk factors for transfusion. Revisions were categorized into subgroups for analysis including: femur only, acetabulum only, both-component, explant/spacer, and second stage reimplantation. Patients undergoing an isolated modular exchange were excluded. Results 29 Patients required at least one unit of blood (16.6%). In the logistic model, significant risk factors for transfusion were lower preoperative hemoglobin, higher preoperative international normalized ratio (INR) and longer operative time (p Conclusions Despite the use of TXA, transfusions are commonly required in revision THA. Preoperative hemoglobin and INR optimization are recommended when medically feasible. Efforts should also be made to decrease operative time when technically possible.