Preoperative anemia increases postoperative complications and mortality following total joint arthroplasty

J Arthroplasty. 2015 May;30(5):846-8. doi: 10.1016/j.arth.2014.12.026. Epub 2015 Jan 10.


Single-institution, large case-controlled study examines the association between preoperative anemia and adverse outcomes following total joint arthroplasty (TJA). We collected data from our institutional database of patients who underwent primary and aseptic revision TJA. Only 2576 patients had anemia preoperatively, and 10,987 patients had hemoglobin within the normal range. Multivariate analysis was used to determine the effect of preoperative anemia on the incidence of medical complications, infection, LOS and mortality. Anemic patients had a higher rate of complications (odds ratio 2.11), namely cardiovascular 26.5% versus 11.8%, and genitourinary 3.9% versus 0.9%. Our study confirms that patients with preoperative anemia are likely to exhibit a higher incidence of postoperative complications following TJA. Preoperative optimization may be needed in an effort to reduce these complications.

Keywords: cardiovascular complications; infection; mortality; postoperative complications; preoperative anemia; total joint arthroplasty.

MeSH terms

  • Aged
  • Anemia / complications*
  • Arthroplasty, Replacement / adverse effects*
  • Arthroplasty, Replacement / mortality
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Preoperative Period
  • Retrospective Studies