Factors leading to blood transfusion among Chinese patients undergoing total knee replacements: a retrospective study.

J Orthop Surg (Hong Kong)

Department of Orthopaedics and Traumatology, University of Hong Kong, Queen Mary Hospital, Hong Kong.

Published: December 2004

Purpose: To investigate the risk factors leading to blood transfusion among Chinese patients undergoing total knee replacement.

Methods: From July 2001 to June 2002, a total of 128 primary total knee replacements were performed in 83 Chinese patients (38 unilateral and 45 one-stage sequential bilateral). No pharmaceutical prophylaxis against deep vein thrombosis was used. The risk factors leading to allogenic blood transfusion were analysed.

Results: The important predictive factors for postoperative blood transfusion were preoperative haemoglobin level (p=0.005), intra-operative blood loss (p<0.001), and bilateral total knee replacements (p<0.001).

Conclusion: To reduce the need of allogenic blood transfusion, we suggest administering erythropoietin or iron supplements to increase the haemoglobin level for patients undergoing total knee replacement. Routine use of intra-operative blood salvage can be considered for patients undergoing one-stage bilateral total knee replacement. Use of a postoperative blood salvage system is recommended for surgeries that may result in major intra-operative blood loss.

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http://dx.doi.org/10.1177/230949900401200203DOI Listing

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