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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(04): 463-469
DOI: 10.1055/s-0040-1715511
Artigo Original
Joelho

Fatores preditivos de hemotransfusão após artroplastia total de joelho[*]

Artikel in mehreren Sprachen: português | English
Alan de Paula Mozella 
1   Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
,
Hugo Alexandre de Araújo Barros Cobra 
1   Centro de Cirurgia do Joelho, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
,
Maria Eugênia Leite Duarte 
2   Divisão de Pesquisa, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil
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Resumo

Objetivos O presente estudo tem como objetivos (1) verificar a incidência e o volume de transfusão sanguínea entre os pacientes submetidos à artroplastia total do joelho (ATJ) unilateral cimentada em um único centro de referência nacional; (2) identificar variáveis pré e perioperatórias que nos permitam identificar os indivíduos sob maior risco (fatores preditores) quanto à necessidade de transfusão sanguínea nas 48 horas subsequentes à realização da cirurgia; (3) estimar o risco de transfusão sanguínea durante as primeiras 48 horas após o procedimento.

Métodos A amostra inicial foi constituída por todos os pacientes submetidos à ATJ entre agosto de 2010 e agosto de 2013. Após aplicação dos critérios de exclusão, permaneceram no estudo 234 pacientes com idade entre 30 e 83 anos, portadores de osteaoartrose primária ou secundária a artrite reumatoide.

Resultados A análise dos resultados mostrou que valores de hemoglobina pré-operatória ≤ 12,3 g/dL e tempo de isquemia ≥ 87 minutos são preditores independentes para hemotransfusão após ATJ, com risco relativo de 2,48 e 1,78, respectivamente. Aproximadamente metade dos pacientes (51,3%) submetidos a ATJ com essas duas variáveis necessitaram de hemotransfusão.

Conclusão A incidência de transfusão sanguínea após ATJ foi de 33,7%. Em média, cada paciente foi transfundido com 480 mL de concentrado de hemácias. Concentração de hemoglobina pré-operatória ≤ 12,3 g/dL (p < 0,001) e tempo de isquemia ≥ 87 minutos (p < 0,047) foram preditores independentes para hemotransfusão em ATJ sob uso de manguito pneumático, com risco relativo de 2,48 e 1,78, respectivamente. A idade, o gênero, diagnóstico ou índice de massa corporal não foram considerados preditores independentes para a necessidade de hemotransfusão até 48 horas após o procedimento de artroplastia.

Palavras-chave

artroplastia do joelho - transfusão de sangue - osteoartrite do joelho

* Trabalho desenvolvido no Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brasil.


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Publikationsverlauf

Eingereicht: 13. Dezember 2019

Angenommen: 01. Juni 2020

Artikel online veröffentlicht:
02. November 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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