AI may identify risk of blood loss, transfusion after orthopedic surgery

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Key takeaways:

  • AI may identify risk of blood loss, transfusions and urgent care after orthopedic surgery.
  • The algorithm used pulse oximeter waveforms from a fingertip sensor to detect cardiovascular capacity and blood loss.

According to published results, an AI algorithm that measures pulse oximeter waveforms in the fingertip may help physicians identify patients at risk for increased blood loss, transfusion and emergency care after orthopedic surgery.

Researchers performed a prospective cohort study of 304 patients (mean age, 68 years) who underwent primary or revision total hip or knee arthroplasty, or abductor tendon repair and reconstruction.

Operating bed

AI may identify risk of blood loss, transfusions and urgent care after orthopedic surgery. Image: Adobe Stock

Patients consented to have pulse oximeter waveforms monitored with a fingertip sensor to determine compensatory reserve index (CRI) on a tablet computer (Cybernet Manufacturing), an AI algorithm that detects remaining cardiovascular capacity and blood loss in surgical patients. According to the study, outcomes included CRI, with thresholds of 0.20, 0.30 and 0.40, systolic blood pressure, heart rate, and risk of blood transfusion and emergency care.

Researchers found CRI successfully identified patients with a significantly higher risk for transfusion and emergency care (P = .000021). Researchers noted patients with a BMI greater than 45 kg/m2 were more likely to have low CRI and increased risk for complications. They also noted systolic blood pressure and heart rate were not associated with increased risk of transfusion until later in treatment.

After secondary analysis of patients with a CRI of 0.40 or more, researchers found these patients had a significantly greater incidence of transfusion vs. the rest of the cohort.

Researchers concluded CRI cutoff levels of 0.30 and 0.40 were more effective vs. a CRI cutoff of 0.20 for high-risk patients.

“These findings suggest that monitoring CRI can be helpful in identifying patients who may need special care, such as cardiovascular monitoring or transfer to the ICU,” the researchers wrote in the study.

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