Blood transfusion rates following shoulder arthroplasty in a high volume UK centre and analysis of risk factors associated with transfusion

Aims: To determine the blood transfusion rates following shoulder arthroplasty and to establish risk factors associated with increased risk of transfusion. Materials and Methods: All shoulder arthroplasty cases performed between January 2012 - March 2017 in a tertiary upper limb unit were identified. Patients who received peri-operative tranexamic acid were excluded. Retrospective review of case notes was completed to identify transfusion rate and risk factors. Univariate and multi-variate analysis was performed to analyse the association between risk factors and transfusion rate. Results: 537 shoulder arthroplasties performed in 474 patients were included. Peri- or post-operative transfusion was required in 21 cases (3.9%). Univariate analysis suggested significant association with age (p=0.005), female sex (0.015), pre-operative haemoglobin / haematocrit (p<0.001), peri-operative drop in haemoglobin (p<0.001) ASA grade (p<0.001) and transfusion rate. Only peri-operative drop in haemoglobin (p<0.001) and ASA grade (p=0.039) retained significance on multi-variable analysis. Conclusions: The blood transfusion rate following shoulder arthoplasty was 3.9%. Greater peri-operative drop in haemoglobin and higher ASA grade were associated with increased risk of transfusion on multivariate analysis.