Starch as a risk factor for increased trans surgical bleeding in total hip arthroplasty.

OBJECTIVE

Establish whether the use of starch in hip arthroplasty is a risk factor for excessive surgical bleeding and requirement of red blood cell transfusion.

METHOD: Analytical observational retrospective study in 240 patients who underwent primary total hip arthroplasty from January 2015 to January 2016. Two groups were formed: starch (94 patients) and non-starch (146 patients). Age, sex, body mass index, preoperative and postoperative hemoglobin, red cell transfusion and surgical bleeding was analyzed.

RESULTS

Starchy group had increased risk of excessive surgical bleeding (OR: 3.58; 95% CI: 2.05- 6.26) and red blood cells transfusion (OR: 3.12; 95% CI: 1.76 -5.5). In the starch group average surgical bleeding was 396 ml (SD: ± 234.94) and a decrease in hemoglobin of 4.6 g/dl (SD± 1.38). The control group had an average bleeding of 271.8 ml (SD: ± 139.22) and decrease in hemoglobin of 3.34 g/dl (SD: ± 1.4).

DISCUSSION: The starch group had higher surgical bleeding and required more often red blood cells transfusion than the non-starch group. We suggest to take in account the possible complications related to the use hydroxyethyl starch.