<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2306-4102</journal-id>
<journal-title><![CDATA[Acta ortopédica mexicana]]></journal-title>
<abbrev-journal-title><![CDATA[Acta ortop. mex]]></abbrev-journal-title>
<issn>2306-4102</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Ortopedia y Traumatología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2306-41022024000200088</article-id>
<article-id pub-id-type="doi">10.35366/115077</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Evaluación de factores asociados a hemorragia mayor en pacientes sometidos a artroplastía total de cadera primaria]]></article-title>
<article-title xml:lang="en"><![CDATA[Evaluation of factors associated with major hemorrhage in patients undergoing primary total hip arthroplasty]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Palmero-Picazo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lassard-Rosenthal]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ríos-Zavala]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital de Traumatología y Ortopedia «Lomas Verdes»  ]]></institution>
<addr-line><![CDATA[Naucalpan de Juárez Estado de México]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Ángeles Lomas Servicio de Traumatología y Ortopedia ]]></institution>
<addr-line><![CDATA[Huixquilucan de Degollado Estado de México]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital de Traumatología y Ortopedia «Lomas Verdes» Unidad Médica de Alta Especialidad Servicio de Alta Especialidad en Reemplazo Articular]]></institution>
<addr-line><![CDATA[Naucalpan de Juárez Estado de México]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2024</year>
</pub-date>
<volume>38</volume>
<numero>2</numero>
<fpage>88</fpage>
<lpage>94</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2306-41022024000200088&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2306-41022024000200088&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2306-41022024000200088&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  el uso de transfusiones sanguíneas conlleva aumentos en los costos hospitalarios y un mayor riesgo de complicaciones médicas y fallecimientos; por lo que es necesario el estudio de la incidencia de eventos de hemorragia mayor y de los factores que se asocien a estos desenlaces en los pacientes que se someten a una artroplastía total de cadera (ATC) primaria.  Material y métodos:  estudio observacional, longitudinal y prospectivo, llevado a cabo en la Unidad Médica de Alta Especialidad de Traumatología y Ortopedia de Lomas Verdes del Instituto Mexicano del Seguro Social, en el Servicio de Reemplazo Articular, en el período comprendido entre el 01 Marzo 2020 al 01 Julio 2020.  Resultados:  la incidencia de hemorragia mayor en pacientes sometidos a ATC primaria fue de 84.8%, al considerarse dos criterios: una disminución de hemoglobina &#8805; 2 g/dl y la necesidad de transfusión &#8805; 2 unidades de glóbulos rojos. Esta cifra aumentó a 87.1% al incluir también el sangrado transquirúrgico en su percentil 75, equivalente a 500 ml. La transfusión de al menos una unidad de glóbulos rojos durante la cirugía se realizó en 68% de los pacientes. El sangrado transquirúrgico alcanzó un máximo de 1,900 ml, con un percentil 75 de 500 ml. A diferencia de otros estudios, en nuestra institución, el género femenino no demostró ser un factor de riesgo significativo para la hemorragia mayor.  Conclusión:  es aconsejable analizar los procedimientos y las particularidades de la cirugía de ATC que puedan estar asociados con un menor riesgo de hemorragia en los pacientes mayores.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  the use of blood transfusions leads to increased hospital costs and an increased risk of medical complications and death. Therefore, it is necessary to study the incidence of major bleeding events and the factors associated with these outcomes in patients undergoing primary total hip arthroplasty (THA).  Material and methods:  observational, longitudinal and prospective study, carried out at the High Specialty Medical Unit of Traumatology and Orthopedics of Lomas Verdes of the Mexican Institute of Social Security, in the Joint Replacement Service, in the period from March 1, 2020 to July 1, 2020.  Results:  the incidence of major bleeding in patients undergoing primary THA was 84.8%, when considering two criteria: a decrease in hemoglobin &#8805; 2 g/dl and the need for transfusion &#8805; 2 units of red blood cells. This Figure increased to 87.1% when also including trans-surgical bleeding at its 75th percentile, equivalent to 500 ml. Transfusion of at least one unit of red blood cells during surgery was performed in 68% of patients. Trans-surgical bleeding reached a maximum of 1,900 ml, with a 75th percentile of 500 ml. Unlike other studies, in our institution, female gender did not prove to be a significant risk factor for major bleeding.  Conclusion:  it is advisable to analyze the procedures and particularities of THA surgery that may be associated with a lower risk of bleeding in older patients.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[artroplastía total de cadera primaria]]></kwd>
<kwd lng="es"><![CDATA[hemorragia]]></kwd>
<kwd lng="es"><![CDATA[factores]]></kwd>
<kwd lng="es"><![CDATA[artroplastía]]></kwd>
<kwd lng="es"><![CDATA[cadera]]></kwd>
<kwd lng="en"><![CDATA[primary total hip arthroplasty]]></kwd>
<kwd lng="en"><![CDATA[hemorrhage]]></kwd>
<kwd lng="en"><![CDATA[factors]]></kwd>
<kwd lng="en"><![CDATA[arthroplasty]]></kwd>
<kwd lng="en"><![CDATA[hip]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Quintero]]></surname>
<given-names><![CDATA[JI]]></given-names>
</name>
<name>
<surname><![CDATA[Cardenas]]></surname>
<given-names><![CDATA[LL]]></given-names>
</name>
<name>
<surname><![CDATA[Navas]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bautista]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Bonilla]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Llinas]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Primary joint arthroplasty surgery: is the risk of major bleeding higher in elderly patients? a retrospective cohort study]]></article-title>
<source><![CDATA[J Arthroplasty]]></source>
<year>2016</year>
<volume>31</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>2264-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Torres-Gómez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mallen-Trejo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores asociados a un sangrado mayor en reemplazo total de cadera]]></article-title>
<source><![CDATA[Acta Ortop Mex]]></source>
<year>2015</year>
<volume>29</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>245-50</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<collab>Committee for Medicinal Products for Human Use (CHMP)</collab>
<source><![CDATA[Guideline on clinical investigation of medicinal products for the treatment of venous thromboembolic disease. EMA/CHMP/41230/2015]]></source>
<year>2016</year>
<publisher-loc><![CDATA[London ]]></publisher-loc>
<publisher-name><![CDATA[European Medicines Agency]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oberweis]]></surname>
<given-names><![CDATA[BS]]></given-names>
</name>
<name>
<surname><![CDATA[Nukala]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenberg]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Guo]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Stuchin]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Radford]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thrombotic and bleeding complications after orthopedic surgery]]></article-title>
<source><![CDATA[Am Heart J]]></source>
<year>2013</year>
<volume>165</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>427-33.e1</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hochreiter]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hejkrlik]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Emmanuel]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Hitzl]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Ortmaier]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Blood loss and transfusion rate in short stem hip arthroplasty. A comparative study]]></article-title>
<source><![CDATA[Int Orthop]]></source>
<year>2017</year>
<volume>41</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>1347-53</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carling]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Jeppsson]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Eriksson]]></surname>
<given-names><![CDATA[BI]]></given-names>
</name>
<name>
<surname><![CDATA[Brisby]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Transfusions and blood loss in total hip and knee arthroplasty: a prospective observational study]]></article-title>
<source><![CDATA[J Orthop Surg Res]]></source>
<year>2015</year>
<volume>10</volume>
<page-range>48</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mitchell]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Betesh]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Ahn]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hume]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
<name>
<surname><![CDATA[Mehta]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Umscheid]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Transfusion thresholds for major orthopedic surgery: a systematic review and metaanalysis]]></article-title>
<source><![CDATA[J Arthroplasty]]></source>
<year>2017</year>
<volume>32</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>3815-21</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Spyropoulos]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Anderson]]></surname>
<given-names><![CDATA[FA]]></given-names>
</name>
<name>
<surname><![CDATA[FitzGerald]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Decousus]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Pini]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chong]]></surname>
<given-names><![CDATA[BH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Predictive and associative models to identify hospitalized medical patients at risk for VTE]]></article-title>
<source><![CDATA[Chest]]></source>
<year>2011</year>
<volume>140</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>706-14</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Decousus]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Tapson]]></surname>
<given-names><![CDATA[VF]]></given-names>
</name>
<name>
<surname><![CDATA[Bergmann]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Chong]]></surname>
<given-names><![CDATA[BH]]></given-names>
</name>
<name>
<surname><![CDATA[Froehlich]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[Kakkar]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factors at admission associated with bleeding risk in medical patients: findings from the IMPROVE investigators]]></article-title>
<source><![CDATA[Chest]]></source>
<year>2011</year>
<volume>139</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>69-79</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="book">
<collab>Presidencia de la República</collab>
<article-title xml:lang=""><![CDATA[Reglamento de la Ley General de Salud en Materia de Investigación para la Salud]]></article-title>
<source><![CDATA[]]></source>
<year>2014</year>
<publisher-loc><![CDATA[México, DF ]]></publisher-loc>
<publisher-name><![CDATA[Diario Oficial de la Federación]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="book">
<source><![CDATA[Declaración de Helsinki de la AMM - Principios éticos para las investigaciones médicas en seres humanos, adoptada por la 64ª Asamblea General, Fortaleza, Brasil, octubre 2013. World Medical Association, editor]]></source>
<year>2015</year>
<publisher-loc><![CDATA[Francia ]]></publisher-loc>
<publisher-name><![CDATA[Asociación Médica Mundial - WMA]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Velasco-Rodríguez]]></surname>
<given-names><![CDATA[VM]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez-Ordaz]]></surname>
<given-names><![CDATA[VA]]></given-names>
</name>
<name>
<surname><![CDATA[Roiz-Hernández]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Huazano-García]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Nieves- Rentería]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Velasco-Rodríguez]]></surname>
<given-names><![CDATA[VM]]></given-names>
</name>
</person-group>
<source><![CDATA[Muestreo y tamaño de la muestra: una guía práctica para personal de salud que realiza investigación]]></source>
<year>2003</year>
<publisher-loc><![CDATA[Buenos Aires ]]></publisher-loc>
<publisher-name><![CDATA[e-libro.net]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
