Journal ArticleDOI
The pre-operative levels of haemoglobin in the blood can be used to predict the risk of allogenic blood transfusion after total knee arthroplasty
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Low pre-operative haemoglobin levels put patients at unnecessary risk and should be corrected prior to surgery, and attempts should be made to correct this before TKA.Abstract:
Aims The pre-operative level of haemoglobin is the strongest predictor
of the peri-operative requirement for blood transfusion after total
knee arthroplasty (TKA). There are, however, no studies reporting
a value that could be considered to be appropriate pre-operatively. This study aimed to identify threshold pre-operative levels of
haemoglobin that would predict the requirement for blood transfusion
in patients who undergo TKA. Patients and Methods Analysis of receiver operator characteristic (ROC) curves of
2284 consecutive patients undergoing unilateral TKA was used to
determine gender specific thresholds predicting peri-operative transfusion
with the highest combined sensitivity and specificity (area under
ROC curve 0.79 for males; 0.78 for females). Results Threshold levels of 13.75 g/dl for males and 12.75 g/dl for females
were identified. The rates of transfusion in males and females,
respectively above these levels were 3.37% and 7.11%, while below
these levels, they were 16.13% and 28.17%. Pre-operative anaemia
increased the rate of transfusion by 6.38 times in males and 6.27
times in females. Blood transfusion was associated with an increased
incidence of early post-operative confusion (odds ratio (OR) = 3.44),
cardiac arrhythmia (OR = 5.90), urinary catheterisation (OR = 1.60),
the incidence of deep infection (OR = 4.03) and mortality (OR =
2.35) one year post-operatively, and increased length of stay (eight
days vs six days, p Conclusion Uncorrected low pre-operative levels of haemoglobin put patients
at potentially modifiable risk and attempts should be made to correct
this before TKA. Target thresholds for the levels of haemoglobin
pre-operatively in males and females are proposed. Take home message: Low pre-operative haemoglobin levels put patients
at unnecessary risk and should be corrected prior to surgery. Cite this article: Bone Joint J 2016;98-B:490–7.read more
Citations
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Journal Article
Predictors of transfusion risk in elective knee surgery : Methods to reduce the use of allogeneic transfusions
TL;DR: In this article, a nomogram was developed using blood volume and predonation hemoglobin to predict transfusion risk and need to predeposit autologous blood in patients undergoing unilateral and bilateral total knee replacements.
Journal ArticleDOI
The incidence and risk factors for allogenic blood transfusion in total knee and hip arthroplasty.
TL;DR: Given the high prevalence and potential risk of transfusion in TJA, interventions for identified risk factors should be used during the perioperative period.
Journal ArticleDOI
Perioperative Blood Management Strategies for Total Knee Arthroplasty.
TL;DR: A highly efficient, safe, and cost‐effective blood management strategy can be constructed to eliminate the need for transfusions associated with total knee arthroplasty.
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Preoperative Patient Profile in Total Hip and Knee Arthroplasty: Predictive of Increased Medicare Payments in a Bundled Payment Model.
Vasili Karas,Beau J. Kildow,Billy T. Baumgartner,Cynthia L. Green,David E. Attarian,Michael P. Bolognesi,Thorsten M. Seyler +6 more
TL;DR: It is demonstrated that specific patient comorbidities and a cumulative increase in comor morbidity and mortality predict increased costs with Medicare payments as a surrogate for cost.
Journal ArticleDOI
Is There a Role for Preoperative Iron Supplementation in Patients Preparing for a Total Hip or Total Knee Arthroplasty
Stephen M. Petis,Brent A. Lanting,Edward M. Vasarhelyi,Douglas D.R. Naudie,Fiona E. Ralley,James L. Howard +5 more
TL;DR: Oral iron therapy reduced the burden of perioperative anemia and reduced utilization of other blood-conserving therapies before THA and TKA.
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