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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2016

01-10-2016 | Knee

Preoperative haemoglobin cut-off values for the prediction of post-operative transfusion in total knee arthroplasty

Authors: Jared Ze Yang Yeh, Jerry Yongqiang Chen, Hamid Rahmatullah Bin Abd Razak, Bryan Huai Gu Loh, Ying Hao, Andy Khye Soon Yew, Shi-Lu Chia, Ngai Nung Lo, Seng Jin Yeo

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2016

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Abstract

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.
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Metadata
Title
Preoperative haemoglobin cut-off values for the prediction of post-operative transfusion in total knee arthroplasty
Authors
Jared Ze Yang Yeh
Jerry Yongqiang Chen
Hamid Rahmatullah Bin Abd Razak
Bryan Huai Gu Loh
Ying Hao
Andy Khye Soon Yew
Shi-Lu Chia
Ngai Nung Lo
Seng Jin Yeo
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4183-1

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