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. 2014 Nov;29(11):2070-7.
doi: 10.1016/j.arth.2014.06.018. Epub 2014 Jun 28.

Primary total knee arthroplasty allogenic transfusion trends, length of stay, and complications: nationwide inpatient sample 2000-2009

Alison K Klika  1 , Travis J Small  1 , Anas Saleh  1 , Caleb R Szubski  1 , Aiswarya Lekshmi Pillai Chandran Pillai  2 , Wael K Barsoum  1
Affiliations

Primary total knee arthroplasty allogenic transfusion trends, length of stay, and complications: nationwide inpatient sample 2000-2009

Alison K Klika et al. J Arthroplasty. 2014 Nov.

Abstract

Perioperative blood loss leading to blood transfusion continues to be an issue for total knee arthroplasty (TKA) patients. The US Nationwide Inpatient Sample (NIS) was used to determine annual trends in allogenic blood transfusion rates, and effects of transfusion on in-hospital mortality, length of stay (LOS), costs, discharge disposition, and complications of primary TKA patients. TKA patients between 2000 and 2009 were included (n = 4,544,999) and categorized as: (1) those who received a transfusion of allogenic blood, and (2) those who did not. Transfusion rates increased from 7.7% to 12.2%. For both transfused and not transfused groups, mortality rates and mean LOS declined, while total costs increased. Transfused patients were associated with adjusted odds ratios of in-hospital mortality (AOR 1.16; P = 0.184), 0.71 ± 0.01 days longer LOS (P < 0.0001), and incurred ($1777 ± 36; P < 0.0001) higher total costs per admission.

Keywords: blood loss; complications; nationwide inpatient sample; total knee arthroplasty; transfusion.

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Figures

Fig. 1
Fig. 1
Diagram showing the number of excluded, transfused, and not transfused cases from the total knee arthroplasty cohort (United States 2000 to 2009)
Fig. 2
Fig. 2
National rates of allogenic and autologous blood transfusions among primary total knee arthroplasty patients (United States 2000 to 2009)
Fig. 3
Fig. 3
Prevalence of comorbidities in transfused and not transfused total knee arthroplasty patients. DM, diabetes mellitus
Fig. 4
Fig. 4
In-hospital mortality rate after total knee arthroplasty in transfused and not transfused patients
Fig. 5
Fig. 5
Mean hospital length of stay in transfused and not transfused total knee arthroplasty patients
Fig. 6
Fig. 6
Mean hospitalization costs of transfused and not transfused total knee arthroplasty patients ($USD)
Fig. 7
Fig. 7
Adjusted effect of allogenic blood transfusion on medical and surgical outcomes after total knee arthroplasty
See this image and copyright information in PMC

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References

    1. Sehat KR, Evans RL, Newman JH. Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account. J Bone Joint Surg Br. 2004 May;86(4):561–565. - PubMed
    1. Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB. An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am. 1999 Jan;81(1):2–10. - PubMed
    1. Bong MR, Patel V, Chang E, Issack PS, Hebert R, Di Cesare PE. Risks associated with blood transfusion after total knee arthroplasty. J Arthroplasty. 2004 Apr;19(3):281–287. - PubMed
    1. Rosencher N, Kerkkamp HE, Macheras G, et al. Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe. Transfusion. 2003 Apr;43(4):459–469. - PubMed
    1. Surgenor DM, Wallace EL, Hao SH, Chapman RH. Collection and transfusion of blood in the United States, 1982-1988. N Engl J Med. 1990 Jun 7;322(23):1646–1651. - PubMed