A LARGE-SCALE U.S. study has highlighted important trends and risks associated with blood transfusion in rheumatoid arthritis (RA) patients undergoing lower extremity joint replacement (LEJR).
Using data from the National Inpatient Sample between 2010 and 2019, researchers analyzed 66,674 RA patients who had undergone joint replacement surgery. They found that 10.9% of patients required blood transfusions, though rates have significantly decreased over time—from nearly one in four patients in 2010 to fewer than 4% in 2019.
Older age, female sex, and comorbidities such as anemia, chronic kidney disease, heart failure, and pulmonary circulation disorders were associated with a higher likelihood of transfusion. However, transfused patients were also at increased risk of postoperative complications, including wound infections, pneumonia, acute kidney injury, sepsis, respiratory failure, and delirium.
“These findings underscore the importance of preoperative screening and perioperative planning for RA patients,” the authors noted. “Targeted blood management strategies may help reduce the need for transfusions and improve surgical outcomes.”
The study suggests that proactive approaches—such as correcting anemia, optimizing comorbidities, and implementing comprehensive perioperative blood management protocols—could lower risks and improve recovery in this vulnerable patient population.
Reference
Geng L et al. Patient characteristics and adverse effects of allogeneic blood transfusion following lower extremity joint replacement in rheumatoid arthritis: a nationwide inpatient sample database study. BMC Rheumatol. 2025;DOI 10.1186/s41927-025-00554-3.
