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Photo courtesy of UAB Hospital
VIENNA—New research suggests that having a higher body mass index (BMI) is associated with a decreased need for blood transfusion among patients undergoing hip or knee replacement surgery.
In this retrospective, single-center study, overweight and obese patients were less likely than patients with a normal BMI to require blood transfusions.
The investigators said these results add to the conflicting body of research examining the association between BMI and blood transfusions in this patient population.
The results were presented at the International Society for Technology in Arthroplasty Annual Congress.
“The results were surprising to us,” said investigator Craig Silverton, DO, of Henry Ford Health System in Detroit, Michigan.
“It goes against the normal thought process. It’s hard to explain, but one theory could be that heavier patients have larger blood volume than patients of normal weight.”
For this study, Dr Silverton and his colleagues evaluated 2399 patients, 1503 of whom underwent knee replacement and 896 of whom underwent hip surgery.
The investigators divided patients into 3 groups according to BMI: normal (BMI less than 25), overweight (BMI of 25 to 29.9), and obese (BMI more than 30).
As BMI increased, there was a significant increase in the estimated blood loss for both types of surgery.
Among hip surgery patients, the estimated blood loss was 268.2± 313.9 mL in patients with a normal BMI, 282.0 ± 208.7 mL in overweight patients, and 330.5 ± 302.4 mL in obese patients.
Among knee surgery patients, the estimated blood loss was 85.7 ± 153.8 mL in patients with a normal BMI, 90.5 ± 164.6 mL in overweight patients, and 89.4 ± 72.4 mL in obese patients.
However, with increasing BMI, there was a significant decrease in the estimated blood volume lost.
Among hip surgery patients, the estimated blood volume lost was 6.12% ± 8.12 in patients with a normal BMI, 4.92% ± 3.05 in overweight patients, and 4.50% ± 3.25 in obese patients.
Among knee surgery patients, the estimated blood volume lost was 2.05% ± 4.00 in patients with a normal BMI, 1.55% ± 2.73 in overweight patients, and 1.26% ± 1.01 in obese patients.
Likewise, there was a significant reduction in transfusion rates as BMI increased.
Among hip surgery patients, the transfusion rate was 34.8% for those with a normal BMI, 27.6% for those who were overweight, and 21.9% for obese patients.
Among knee surgery patients, the transfusion rate was 17.3% for those with a normal BMI, 11.4% for those who were overweight, and 8.3% for obese patients.
The investigators noted that there was no identifiable relationship between BMI and deep vein thrombosis, pulmonary embolism, myocardial infarction, length of hospital stay, 30-day readmission rate, or preoperative hemoglobin level.
There was a trend toward increased deep surgical site infections with increased BMI, but only among patients who underwent hip surgery. 
Photo courtesy of UAB Hospital
VIENNA—New research suggests that having a higher body mass index (BMI) is associated with a decreased need for blood transfusion among patients undergoing hip or knee replacement surgery.
In this retrospective, single-center study, overweight and obese patients were less likely than patients with a normal BMI to require blood transfusions.
The investigators said these results add to the conflicting body of research examining the association between BMI and blood transfusions in this patient population.
The results were presented at the International Society for Technology in Arthroplasty Annual Congress.
“The results were surprising to us,” said investigator Craig Silverton, DO, of Henry Ford Health System in Detroit, Michigan.
“It goes against the normal thought process. It’s hard to explain, but one theory could be that heavier patients have larger blood volume than patients of normal weight.”
For this study, Dr Silverton and his colleagues evaluated 2399 patients, 1503 of whom underwent knee replacement and 896 of whom underwent hip surgery.
The investigators divided patients into 3 groups according to BMI: normal (BMI less than 25), overweight (BMI of 25 to 29.9), and obese (BMI more than 30).
As BMI increased, there was a significant increase in the estimated blood loss for both types of surgery.
Among hip surgery patients, the estimated blood loss was 268.2± 313.9 mL in patients with a normal BMI, 282.0 ± 208.7 mL in overweight patients, and 330.5 ± 302.4 mL in obese patients.
Among knee surgery patients, the estimated blood loss was 85.7 ± 153.8 mL in patients with a normal BMI, 90.5 ± 164.6 mL in overweight patients, and 89.4 ± 72.4 mL in obese patients.
However, with increasing BMI, there was a significant decrease in the estimated blood volume lost.
Among hip surgery patients, the estimated blood volume lost was 6.12% ± 8.12 in patients with a normal BMI, 4.92% ± 3.05 in overweight patients, and 4.50% ± 3.25 in obese patients.
Among knee surgery patients, the estimated blood volume lost was 2.05% ± 4.00 in patients with a normal BMI, 1.55% ± 2.73 in overweight patients, and 1.26% ± 1.01 in obese patients.
Likewise, there was a significant reduction in transfusion rates as BMI increased.
Among hip surgery patients, the transfusion rate was 34.8% for those with a normal BMI, 27.6% for those who were overweight, and 21.9% for obese patients.
Among knee surgery patients, the transfusion rate was 17.3% for those with a normal BMI, 11.4% for those who were overweight, and 8.3% for obese patients.
The investigators noted that there was no identifiable relationship between BMI and deep vein thrombosis, pulmonary embolism, myocardial infarction, length of hospital stay, 30-day readmission rate, or preoperative hemoglobin level.
There was a trend toward increased deep surgical site infections with increased BMI, but only among patients who underwent hip surgery.
Photo courtesy of UAB Hospital
VIENNA—New research suggests that having a higher body mass index (BMI) is associated with a decreased need for blood transfusion among patients undergoing hip or knee replacement surgery.
In this retrospective, single-center study, overweight and obese patients were less likely than patients with a normal BMI to require blood transfusions.
The investigators said these results add to the conflicting body of research examining the association between BMI and blood transfusions in this patient population.
The results were presented at the International Society for Technology in Arthroplasty Annual Congress.
“The results were surprising to us,” said investigator Craig Silverton, DO, of Henry Ford Health System in Detroit, Michigan.
“It goes against the normal thought process. It’s hard to explain, but one theory could be that heavier patients have larger blood volume than patients of normal weight.”
For this study, Dr Silverton and his colleagues evaluated 2399 patients, 1503 of whom underwent knee replacement and 896 of whom underwent hip surgery.
The investigators divided patients into 3 groups according to BMI: normal (BMI less than 25), overweight (BMI of 25 to 29.9), and obese (BMI more than 30).
As BMI increased, there was a significant increase in the estimated blood loss for both types of surgery.
Among hip surgery patients, the estimated blood loss was 268.2± 313.9 mL in patients with a normal BMI, 282.0 ± 208.7 mL in overweight patients, and 330.5 ± 302.4 mL in obese patients.
Among knee surgery patients, the estimated blood loss was 85.7 ± 153.8 mL in patients with a normal BMI, 90.5 ± 164.6 mL in overweight patients, and 89.4 ± 72.4 mL in obese patients.
However, with increasing BMI, there was a significant decrease in the estimated blood volume lost.
Among hip surgery patients, the estimated blood volume lost was 6.12% ± 8.12 in patients with a normal BMI, 4.92% ± 3.05 in overweight patients, and 4.50% ± 3.25 in obese patients.
Among knee surgery patients, the estimated blood volume lost was 2.05% ± 4.00 in patients with a normal BMI, 1.55% ± 2.73 in overweight patients, and 1.26% ± 1.01 in obese patients.
Likewise, there was a significant reduction in transfusion rates as BMI increased.
Among hip surgery patients, the transfusion rate was 34.8% for those with a normal BMI, 27.6% for those who were overweight, and 21.9% for obese patients.
Among knee surgery patients, the transfusion rate was 17.3% for those with a normal BMI, 11.4% for those who were overweight, and 8.3% for obese patients.
The investigators noted that there was no identifiable relationship between BMI and deep vein thrombosis, pulmonary embolism, myocardial infarction, length of hospital stay, 30-day readmission rate, or preoperative hemoglobin level.
There was a trend toward increased deep surgical site infections with increased BMI, but only among patients who underwent hip surgery.