PREDICTORS OF HIGH RED BLOOD CELL CONCENTRATE UTILIZATION IN PATIENTS UNDERGOING ELECTIVE HIP ARTHROPLASTY

@article{ferreiragomes2026predictors,
  title = {{PREDICTORS OF HIGH RED BLOOD CELL CONCENTRATE UTILIZATION IN PATIENTS UNDERGOING ELECTIVE HIP ARTHROPLASTY}},
  author = {Ricardo FERREIRA-GOMES and Erick Frota Gomes FIGUEIREDO and Greice Mariana THOMAZ-BARBOSA and Thais Caroline Torres RIBEIRO and Eduarda da Costa QUEIROZ DA SILV and Odvania Mendes de MELO and Adriana Gomes RODRIGUES FEITOZA and Lailla Melissa Castro MORAES and Antonia Gerarda PAMELLA REIMERS and Eliane Aparecida PEIXOTO PAULO and Robson Luís Oliveira AMORIM and Silvânia da Conceição FURTADO and Bruno Bellaguarda BATISTA},
  journal = {Hematology, Transfusion and Cell Therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.htct.2026.107386},
  url = {https://doi.org/10.1016/j.htct.2026.107386},
  note = {CC BY},
}

TY  - JOUR
TI  - PREDICTORS OF HIGH RED BLOOD CELL CONCENTRATE UTILIZATION IN PATIENTS UNDERGOING ELECTIVE HIP ARTHROPLASTY
AU  - Ricardo FERREIRA-GOMES
AU  - Erick Frota Gomes FIGUEIREDO
AU  - Greice Mariana THOMAZ-BARBOSA
AU  - Thais Caroline Torres RIBEIRO
AU  - Eduarda da Costa QUEIROZ DA SILV
AU  - Odvania Mendes de MELO
AU  - Adriana Gomes RODRIGUES FEITOZA
AU  - Lailla Melissa Castro MORAES
AU  - Antonia Gerarda PAMELLA REIMERS
AU  - Eliane Aparecida PEIXOTO PAULO
AU  - Robson Luís Oliveira AMORIM
AU  - Silvânia da Conceição FURTADO
AU  - Bruno Bellaguarda BATISTA
PY  - 2026
DA  - 2026/10/23
JO  - Hematology, Transfusion and Cell Therapy
DO  - 10.1016/j.htct.2026.107386
UR  - https://doi.org/10.1016/j.htct.2026.107386
AB  - 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.
SN  - 2531-1379
SN  - 2531-1387
ER  -