Volume 59, Issue 7 pp. 2324-2333
PATIENT BLOOD MANAGEMENT

Transfusion trends in hip arthroplasty in Korea: a nationwide study by the Korean National Health Insurance Service

You-Sung Suh MD, PhD

Corresponding Author

You-Sung Suh MD, PhD

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul, South Korea

Address reprint requests to: Jae-Hwi Nho, MD, PhD, Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea; e-mail: [email protected].Search for more papers by this author
Jeong Jae Lee MD, PhD

Jeong Jae Lee MD, PhD

The Center for Bloodless Medicine and Surgery and Patient Blood Management, Soonchunhyang University Hospital Seoul, Seoul, South Korea

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Jae-Hwi Nho MD, PhD

Jae-Hwi Nho MD, PhD

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul, South Korea

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Jae-Jun Lee MD

Jae-Jun Lee MD

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul, South Korea

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Sung Hun Won MD, PhD

Sung Hun Won MD, PhD

Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul, South Korea

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Hyeon-Jong Yang MD, PhD

Hyeon-Jong Yang MD, PhD

Department of Pediatrics, SCH Biomedical Informatics Research Unit, Soonchunhyang University Hospital Seoul, Seoul, South Korea

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First published: 25 April 2019
Citations: 13
This work was supported by the Soonchunhyang University Research Fund.

Abstract

BACKGROUND

Hip arthroplasties are strongly associated with blood transfusion to compensate for perioperative bleeding. The purpose of this study was to evaluate the trends in transfusion associated with hip arthroplasties, using nationwide data supplied by the National Health Insurance Service.

STUDY DESIGN AND METHODS

We used data from nationwide claims database of the Health Insurance Review Assessment Service. The data managed by the National Health Insurance Service were used to identify 161,934 hip arthroplasties under three categories, including bipolar hemiarthroplasty, total hip arthroplasty, and revision arthroplasty, from 2007 to 2015. The transfusion rates, transfusion amounts, the proportion of transfusion, and cost associated with each type of operation were investigated and stratified according to age, sex, hospital type, and region.

RESULTS

The proportion of patients receiving any allogeneic transfusion was 81.1% in 9 years. The overall proportion of transfusion was 7% fresh frozen plasma, 12% platelets, and 77% RBCs. The average count of transfusions was 4.1 in bipolar hemiarthroplasty (343,815/83,729), 4.3 in total hip arthroplasty (196,869/46,097), and 8.7 in revision arthroplasty (35,044/4,024) from 2007 to 2015.

CONCLUSION

In this nationally representative study of trends in transfusion associated with hip arthroplasty, we observed significantly high rates of blood transfusion among patients undergoing hip arthroplasties. Although the overall amount of transfusion declined, the allogeneic transfusion rate was still high from 2007 to 2015 in Korea, and higher than other countries are reporting.

CONFLICT OF INTEREST

The authors have disclosed no conflicts of interest.

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