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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 and March 2017 in a tertiary upper limb unit were identified. Patients who received perioperative tranexamic acid were excluded. Retrospective review of case notes was completed to identify transfusion rate and risk factors. Univariate and multivariate analysis were performed to analyse the association between risk factors and transfusion rate. Results Five hundred and thirty-seven 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), preoperative haemoglobin/haematocrit (p < 0.001), perioperative drop in haemoglobin (p < 0.001), ASA grade (p < 0.001) and transfusion rate. Only perioperative drop in haemoglobin (p < 0.001) and American Society of Anaesthesiologist score (ASA) grade (p = 0.039) retained significance on multivariable analysis. Conclusions The blood transfusion rate following shoulder arthroplasty was 3.9%. Greater perioperative drop in haemoglobin and higher ASA grade were associated with increased risk of transfusion on multivariate analysis.