Perioperative Blood Management Programme in Jehovah’s Witnesses Undergoing Total Hip Arthroplasty
Giuseppe Solarino,
Giovanni Vicenti,
Davide Bizzoca,
Domenico Zaccari,
Walter Ginestra,
Davide Ferorelli,
Matteo D’aprile,
Biagio Moretti
Affiliations
Giuseppe Solarino
Orthopaedics Unit, Department DiBRaiN, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy
Giovanni Vicenti
Orthopaedics Unit, Department DiBRaiN, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy
Davide Bizzoca
Orthopaedics Unit, Department DiBRaiN, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy
Domenico Zaccari
Orthopaedics Unit, Department DiBRaiN, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy
Walter Ginestra
Orthopaedics Unit, Department DiBRaiN, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy
Davide Ferorelli
Section of Legal Medicine, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, AOU Consorziale Policlinico di Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
Matteo D’aprile
Orthopaedics Unit, Department DiBRaiN, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy
Biagio Moretti
Orthopaedics Unit, Department DiBRaiN, University of Bari “Aldo Moro”, AOU Consorziale Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy
Total hip arthroplasties aim to improve quality of life and reduce pain in patients suffering from late-stage hip osteoarthritis. On the other hand, it may represent a risky surgical procedure in people who refuse blood products because of religious beliefs, such as Jehovah’s Witnesses (JW). Preoperative optimisation protocols of these patients allow medical professionals to perform arthroplasties in a safer manner, avoiding allogeneic blood transfusion. In our retrospective study, two groups of patients were evaluated. Group 1 included JW patients who underwent a preoperative Hb optimisation program; Group 2 included non-JW patients authorizing transfusion in case of necessity. Differences in Hb levels were as follows: before surgery (JW 14.24 ± 1.10 vs. non-JW 12.48 ± 1.00, p-value ≤ 0.05), and after surgery (day 1 Hb: JW 12.88 ± 0.90 vs. non-JW 10.04 ± 1.30, p-value ≤ 0.05; day 3 Hb: JW 14.65 ± 0.80 vs. non-JW 9.10 ± 0.90 p-value ≤ 0.05). Moreover, cost-effectiveness strategies were evaluated in both groups. Our findings support that patient blood management programs are a safe and good strategy in hip prosthetic surgery, decreasing risks and transfusion overuse.
