Allogeneic Transfusion Rate and Related Factors in Primary Total Knee Arthroplasty
10.3969/j.issn.1674-9081.2014.02.002
- VernacularTitle:全膝关节置换术围手术期异体输血率及其影响因素
- Author:
Hui-Ming PENG
1
;
Xi-Sheng WENG
;
Ji-Liang ZHAI
;
Jin LIN
;
Jin JIN
;
Wen-Wei QIAN
;
Li-Juan ZHAO
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院骨科
- Keywords:
knee joint;
arthroplasty;
perioperation;
allogeneic transfusion;
influencing factor
- From:
Medical Journal of Peking Union Medical College Hospital
2014;(2):135-141
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the transfusion rates and identify perioperative factors associated with allogeneic blood transfusion ( AllTx) after primary total knee arthroplasty ( TKA) with routine use of low-molecu-lar-weight heparins .Methods We retrospectively studied the transfusion rate of 1165 consecutive patients who underwent primary TKA between January 2005 and December 2011 .Totally 34 independent variables were ana-lyzed in 617 primary unilateral TKAs without autologous blood predonation for requirement of AllTx .Multiple re-gression analysis model was used to identify risk factors associated with perioperative blood transfusion .Results Overall, 58.2% (678/1165 ) of patients required AllTx .The median number of units transfused was 2.7 U ( range:1 to 13 U).The AllTx rate was 40.0%(278/695) in unilateral TKA procedures and 85.1%(400/470) in one-stage bilateral TKA procedures .Univariate analysis demonstrated the risk of transfusion was independently predicted by the patients'age at surgery ( P<0.0001 ) , preoperative hematocrit ( P<0.0001 ) , preoperative he-moglobin concentration (P<0.0001), American Society of Anesthesiologists (ASA) score ≥3 (P=0.004), surgical time ( P=0.004 ) , and tourniquet time ( P=0.050 ) .Multivariate Logistic regression analysis confirmed significant relationship between allogeneic blood transfusion and age ( P <0.0001 ) , preoperative hemoglobin ( P<0.0001 ) , and surgical time ( P<0.0001 ) .Conclusions AllTx rate is high in TKA procedures , especial-ly in one-stage bilateral TKA procedures .Patient's age, preoperative hemoglobin level , and surgical time are helpful in identifying high-risk patients who require postoperative blood transfusion .
