PURPOSE: The purpose of this study is to determine preoperative haemoglobin cut-off values that could accurately predict post-operative transfusion outcome in patients undergoing primary unilateral total knee arthroplasty (TKA). This will allow surgeons to provide selective preoperative type and screen to only patients at high risk of transfusion. METHODS: A total of 1457 patients diagnosed with osteoarthritis and underwent primary unilateral TKA between January 2012 and December 2014 were retrospectively reviewed. Logistic regression analyses were applied to identify factors that could predict transfusion outcome. RESULTS: A total of 37 patients (2.5 %) were transfused postoperatively. Univariate analysis revealed preoperative haemoglobin (p < 0.001), age (p < 0.001), preoperative haematocrit (p < 0.001), and preoperative creatinine (p < 0.001) to be significant predictors. In the multivariate analysis with patients dichotomised at 70 years of age, preoperative haemoglobin remained significant with adjusted odds ratio of 0.33. Receiver operating characteristic curve identified the preoperative haemoglobin cut-off values to be 12.4 g/dL (AUC = 0.86, sensitivity = 87.5 %, specificity = 77.2 %) and 12.1 g/dL (AUC = 0.85, sensitivity = 69.2 %, specificity = 87.1 %) for age above and below 70, respectively. CONCLUSIONS: The authors recommend preoperative haemoglobin cut-off values of 12.4 g/dL for age above 70 and 12.1 g/dL for age below 70 to be used to predict post-operative transfusion requirements in TKA. To maximise the utilisation of blood resources, the authors recommend that only patients with haemoglobin level below the cut-off should receive routine preoperative type and screen before TKA. LEVEL OF EVIDENCE: IV.
PURPOSE: The purpose of this study is to determine preoperative haemoglobin cut-off values that could accurately predict post-operative transfusion outcome in patients undergoing primary unilateral total knee arthroplasty (TKA). This will allow surgeons to provide selective preoperative type and screen to only patients at high risk of transfusion. METHODS: A total of 1457 patients diagnosed with osteoarthritis and underwent primary unilateral TKA between January 2012 and December 2014 were retrospectively reviewed. Logistic regression analyses were applied to identify factors that could predict transfusion outcome. RESULTS: A total of 37 patients (2.5 %) were transfused postoperatively. Univariate analysis revealed preoperative haemoglobin (p < 0.001), age (p < 0.001), preoperative haematocrit (p < 0.001), and preoperative creatinine (p < 0.001) to be significant predictors. In the multivariate analysis with patients dichotomised at 70 years of age, preoperative haemoglobin remained significant with adjusted odds ratio of 0.33. Receiver operating characteristic curve identified the preoperative haemoglobin cut-off values to be 12.4 g/dL (AUC = 0.86, sensitivity = 87.5 %, specificity = 77.2 %) and 12.1 g/dL (AUC = 0.85, sensitivity = 69.2 %, specificity = 87.1 %) for age above and below 70, respectively. CONCLUSIONS: The authors recommend preoperative haemoglobin cut-off values of 12.4 g/dL for age above 70 and 12.1 g/dL for age below 70 to be used to predict post-operative transfusion requirements in TKA. To maximise the utilisation of blood resources, the authors recommend that only patients with haemoglobin level below the cut-off should receive routine preoperative type and screen before TKA. LEVEL OF EVIDENCE: IV.
Entities:
Keywords:
Haemoglobin; Knee replacement; Preoperative; Total knee arthroplasty; Transfusion
Authors: W A van Klei; K G M Moons; A T Rheineck-Leyssius; C J Kalkman; C L G Rutten; J T A Knape; D E Grobbee Journal: Br J Anaesth Date: 2002-08 Impact factor: 9.166
Authors: Matthew R Bong; Vipul Patel; Eric Chang; Paul S Issack; Rudi Hebert; Paul E Di Cesare Journal: J Arthroplasty Date: 2004-04 Impact factor: 4.757
Authors: Jai Hyung Park; Mohammad R Rasouli; S M Javad Mortazavi; Anthony T Tokarski; Mitchell G Maltenfort; Javad Parvizi Journal: J Bone Joint Surg Am Date: 2013-10-02 Impact factor: 5.284
Authors: Mitchell R Klement; Ashwin Peres-Da-Silva; Brian T Nickel; Cynthia L Green; Samuel S Wellman; David E Attarian; Michael P Bolognesi; Thorsten M Seyler Journal: Clin Orthop Relat Res Date: 2017-08-07 Impact factor: 4.176
Authors: Zachary K Christopher; Marcus R Bruce; Emily G Reynolds; Mark J Spangehl; Joshua S Bingham; Molly B Kraus Journal: Arthroplast Today Date: 2020-11-26
Authors: Alexander J Acuña; Daniel Grits; Linsen T Samuel; Ahmed K Emara; Atul F Kamath Journal: Clin Orthop Relat Res Date: 2021-03-01 Impact factor: 4.755
Authors: Paula Dhiman; Victoria N Gibbs; Gary S Collins; Ben Van Calster; Gardash Bakhishli; George Grammatopoulos; Andrew J Price; Adrian Taylor; Mike F Murphy; Ben J L Kendrick; Antony J R Palmer Journal: Transfus Med Date: 2022-05-11 Impact factor: 2.057