NDLI: Occurrence and determinants of poor response to short-term pre-operative erythropoietin treatment.

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Occurrence and determinants of poor response to short-term pre-operative erythropoietin treatment.

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Occurrence and determinants of poor response to short-term pre-operative erythropoietin treatment.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Van Haelst, I. M. M. Egberts, A. C. G. Doodeman, H. J. Van Solinge, W. W. Kalkman, C. J. Bennis, M. Traast, H. S. Van Klei, W. A.
Description	Country affiliation: Netherlands Author Affiliation: van Haelst IM ( Department of Clinical Pharmacy, Medical Center Alkmaar, Wilhelminalaan 12, Alkmaar, The Netherlands.)
Abstract	BACKGROUND: This study aimed to explore the occurrence and determinants of poor response to short-term pre-operative erythropoietin treatment and the effect of such poor response on transfusion in total hip arthroplasty patients. METHODS: We studied total hip arthroplasty patients who received erythropoietin before surgery. The primary outcome was the pre-operative increase in haemoglobin (delta haemoglobin) as response to erythropoietin therapy. Additionally, patients were classified in tertiles based on this delta haemoglobin: poor responders (cases), responders and good responders (controls) to erythropoietin. Patient characteristics, comedication and co-morbidity were collected as potential determinants of erythropoietin response. Regression techniques were used to estimate the strength of the associations and to assess the effect of poor response on transfusion requirement. RESULTS: A total of 379 patients receiving erythropoietin were eligible to enter the study. Mean delta haemoglobin was 19.3 g/l (standard deviation 9.4). Factors significantly associated with delta haemoglobin were the use of angiotensin II antagonists [-3.1 g/l; 95% confidence interval (CI) -5.7 to -0.6] and vitamin K antagonists (-6.9 g/l; 95% CI -10.0 to -0.2), together with body mass index (BMI) (-0.3 g/l per unit>; 95% CI -0.5 to -0.2). The additional case-control analysis yielded comparable results. Poor response to erythropoietin was associated with an increased transfusion risk (odds ratio 4.6, 95% CI 2.0-11). CONCLUSION: Use of angiotensin II receptor antagonists and vitamin K antagonists, and having a high BMI were determinants of poor response to short-term pre-operative erythropoietin treatment in total hip arthroplasty patients. Poor responders had a higher risk for perioperative blood transfusion.
File Format	HTM / HTML
ISSN	00015172
Issue Number	3
Volume Number	57
e-ISSN	00015172
Journal	Acta Anaesthesiologica Scandinavica
Language	English
Publisher	Wiley
Publisher Date	2013-03-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Anemia Drug Therapy Erythropoietin Therapeutic Use Preoperative Care Aged Blood Arthroplasty, Replacement, Hip Blood Transfusion Comorbidity Data Interpretation, Statistical Female Hemoglobins Analysis Humans Male Recombinant Proteins Treatment Failure Treatment Outcome Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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