Correlation factors for allogeneic blood transfusion after total knee arthroplasty

doi:10.3969/j.issn.2095-4344.1266

Abstract

Abstract:

BACKGROUND: Due to massive blood loss during perioperative period, some patients need to receive allogeneic blood transfusion after total knee arthroplasty, which is risky. How to reduce the rate of allogeneic blood transfusion after total knee arthroplasty has become an issue of concern in clinical practice.

OBJECTIVE: To investigate the rate of allogeneic blood transfusion after total knee arthroplasty, and analyze its risk factors, thus reducing the rate of allogeneic blood transfusion in patients with total knee arthroplasty.

METHODS: Totally 687 patients undergoing total knee arthroplasty at the First Affiliated Hospital of Zhengzhou University from January 2014 to May 2018 were analyzed retrospectively. Patients were divided into non-allogeneic (n=490) and allogeneic blood transfusion (n=197) groups according to whether they had allogeneic blood transfusion after total knee arthroplasty. The postoperative indexes related to allogeneic blood transfusion were recorded. Potential risk factors for allogeneic transfusion were analyzed statistically via univariate and multivariate regression analysis. The study was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University in March 2019.

RESULTS AND CONCLUSION: (1) Totally 197 (28.7%) patients of 687 received allogeneic blood transfusion after total knee arthroplasty. (2) The differences were significant in the age, sex, pre-diagnosis, pre-hemoglobin level, pre-hematocrit and drainage tube placement between two groups (P < 0.05). (3) Age, sex, pre-hemoglobin level, pre-hematocrit and drainage tube placement were significantly different between two groups in multivariate regression analysis (P < 0.05). (4) These results indicate that aged female, pre-anemia, pre-hematocrit less than the normal level and postoperative drainage tube placement are independent risk factors for increasing the allogeneic blood transfusion rate after total knee arthroplasty. Patients who were with rheumatoid arthritis and whose postoperative mean arterial pressure has a reduction of ≥ 20 mm Hg have an increased postoperative blood transfusion rate. There is no significant difference in the allogeneic blood transfusion rate between simultaneous bilateral, staged bilateral total knee arthroplasties and unilateral total knee arthroplasty.

Key words: bone implants, artificial prosthesis, knee osteoarthritis, total knee arthroplasty, osteoarthritis, postoperative blood transfusion, allogeneic blood transfusion, risk factors

CLC Number:

R457|R684|R318

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R457|R684|R318

Xin Chaofei, Xu Jianzhong, Zhao Shixin, Tian Jinxiang, Chang Yingjian, Shi Jianming. Correlation factors for allogeneic blood transfusion after total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(28): 4461-4467.

Figures/Tables 3

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