{ "abstract": "Introduction: High red blood cell concentrate utilization in elective hip arthroplasty is associated with increased blood component use, higher hospital costs, and more complex perioperative management. Identifying patients at greater risk of high transfusion requirements may support Patient Blood Management (PBM) strategies and optimize transfusion planning. Objective: To identify clinical and perioperative predictors of high red blood cell concentrate utilization in patients undergoing elective hip arthroplasty. Materials and methods: This retrospective observational study was conducted at Fundação Hospital Adriano Jorge (FHAJ), a tertiary referral hospital in the Brazilian Amazon region, including 34 transfused patients who underwent elective hip arthroplasty between 2024 and 2025. Patients were classified into standard consumption (1–2 units; n = 22) and high consumption (≥3 units; n = 12). Age, preoperative hemoglobin, prothrombin time (PT), and operative time were evaluated. Student’s t-test or Mann–Whitney test was applied according to data distribution. Patients with complete data (n = 26) were analyzed using Firth’s penalized logistic regression to identify factors independently associated with high consumption. Prothrombin time was rescaled so the odds ratio represented 0.1-unit increments. The 95% confidence intervals and p values were obtained by penalized likelihood profile. Predictive performance was assessed by ROC analysis. Statistical significance was set at 5%. Results: Patients with high consumption showed a trend toward longer operative time in the univariate analysis (194.1 ± 80.2 vs. 140.5 ± 76.2 minutes; p = 0.063). Age (p = 0.493), preoperative hemoglobin (p = 0.894), and prothrombin time (p = 0.175) did not differ significantly between groups. In Firth’s penalized logistic regression, prothrombin time was independently associated with high consumption: each 0.1-unit increase was associated with an OR of 2.23 (95% CI, 1.07–5.70; p = 0.030). Operative time was also independently associated with high consumption (OR = 1.013/minute; 95% CI, 1.000–1.029; p = 0.042), whereas age was not (OR = 1.043; 95% CI, 0.967–1.151; p = 0.288). Prothrombin time showed moderate discriminatory ability for predicting high consumption (AUC = 0.738; 95% CI, 0.524–0.953; p = 0.029), with a cutoff of ≥1.19, sensitivity of 88.9%, and specificity of 64.7%. Discussion and conclusion: Although prothrombin time was not associated with high consumption in the univariate analysis, an independent association emerged after adjustment for age and operative time in Firth’s penalized logistic regression, suggesting an independent effect after controlling for potential confounders. Operative time was also independently associated with high red blood cell concentrate utilization, whereas age and preoperative hemoglobin were not. The moderate discriminatory ability of prothrombin time supports its use for transfusion risk stratification. The association with operative time further suggests that intraoperative factors contribute to increased transfusion requirements. Despite the small multivariable sample, these findings suggest that preoperative coagulation assessment combined with perioperative planning may help anticipate transfusion demand and guide Patient Blood Management strategies.", "abstract_shown": true, "affiliations": [ "Universidade Federal do Amazonas (UFAM), Manaus, Brazil", "Universidade Estadual do Amazonas (UEA), Manaus, Brazil", "Fundação Hospital Adriano Jorge (FHAJ), Manaus, Brazil", "Faculdade Metropolitana de Manaus (FAMETRO), Manaus, Brazil" ], "article_type": null, "arxiv": null, "author_total": 13, "authors": [ { "affs": [ 0 ], "name": "Ricardo FERREIRA-GOMES" }, { "affs": [ 1 ], "name": "Erick Frota Gomes FIGUEIREDO" }, { "affs": [ 2 ], "name": "Greice Mariana THOMAZ-BARBOSA" }, { "affs": [ 3 ], "name": "Thais Caroline Torres RIBEIRO" }, { "affs": [ 3 ], "name": "Eduarda da Costa QUEIROZ DA SILV" }, { "affs": [ 2 ], "name": "Odvania Mendes de MELO" }, { "affs": [ 2 ], "name": "Adriana Gomes RODRIGUES FEITOZA" }, { "affs": [ 2 ], "name": "Lailla Melissa Castro MORAES" }, { "affs": [ 3 ], "name": "Antonia Gerarda PAMELLA REIMERS" }, { "affs": [ 2 ], "name": "Eliane Aparecida PEIXOTO PAULO" }, { "affs": [ 0 ], "name": "Robson Luís Oliveira AMORIM" }, { "affs": [ 0 ], "name": "Silvânia da Conceição FURTADO" }, { "affs": [ 0 ], "name": "Bruno Bellaguarda BATISTA" } ], "bibtex": "https://research.draconitic.com/paper/ew2p5e4207ng3.bib", "cited_by": 0, "doi": "10.1016/j.htct.2026.107386", "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2531137926011338", "id": "ew2p5e4207ng3", "issns": [ "2531-1379", "2531-1387" ], "landing_url": "https://doi.org/10.1016/j.htct.2026.107386", "language": "en", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "lcc", "RC633-647.5" ], [ "openalex", "2704|Blood transfusion and management" ] ], "openalex": "W7223121583", "pdf_url": "https://www.sciencedirect.com/science/article/pii/S2531137926011338/pdf", "pmcid": null, "pmid": null, "published": "2026-10-23", "publisher": "Elsevier", "ris": "https://research.draconitic.com/paper/ew2p5e4207ng3.ris", "sources": [ { "first_seen": "2026-10-30T13:43:20Z", "native_id": "91aecfcd80b945588005a1f4980dc060", "source": "doaj", "url": "https://doi.org/10.1016/j.htct.2026.107386" } ], "subjects": [ { "field": "medicine", "origin": "lcc:RC633-647.5", "subfield": "endocrinology-metabolism" } ], "title": "PREDICTORS OF HIGH RED BLOOD CELL CONCENTRATE UTILIZATION IN PATIENTS UNDERGOING ELECTIVE HIP ARTHROPLASTY", "title_text": "PREDICTORS OF HIGH RED BLOOD CELL CONCENTRATE UTILIZATION IN PATIENTS UNDERGOING ELECTIVE HIP ARTHROPLASTY", "type": "peer-reviewed", "updated_at": "2026-10-30T13:43:20Z", "url": "https://research.draconitic.com/paper/ew2p5e4207ng3", "venue": "Hematology, Transfusion and Cell Therapy", "versions": [] }