Influence of Hemoglobin Levels on Inpatient Rehabilitation Outcomes after Total Knee Arthroplasty

Diamond, Paul T.; Conaway, Mark R.; Mody, Samir H.; Bhirangi, Kiran

doi:10.1016/j.arth.2005.09.006

Cited by 45 publications

(22 citation statements)

References 32 publications

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“…ABTD was found to be effective in reducing allogeneic blood transfusions but not in achieving high postoperative hemoglobin levels. A high postoperative hemoglobin level has been reported to be associated with better rehabilitation outcomes after TKA [58]. The present findings suggest that ABTD was not useful in achieving high postoperative hemoglobin levels to enhance rehabilitation, similar to the findings of other studies [57, 59].…”

Section: Discussionsupporting

confidence: 84%

The efficacy and safety of autologous blood transfusion drainage in patients undergoing total knee arthroplasty: a meta-analysis of 16 randomized controlled trials

Pan

Hong

Xie

et al. 2016

BMC Musculoskelet Disord

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BackgroundAutologous blood transfusion drainage (ABTD) has been used for many years to reduce blood loss in total knee arthroplasty (TKA). We evaluate the current evidence concerning the efficiency and safety of ABTD used in TKA compared with conventional suction drainage (CSD).MethodsWe performed a systematic literature search of the PubMed, Embase, Cochrane Library and four Chinese databases. All randomized controlled trials (RCTs) that compared the effects of ABTD versus CSD in TKA were included in the meta-analysis.ResultsSixteen RCTs involving 1534 patients who compared the effects of ABTD versus CSD were included. Five of the RCTs were performed in Asia, ten in Europe, and one in North America. Patients in the ABTD group had a lower blood transfusion rate (OR: 0.25 [0.13, 0.47]; Z = 4.27, P < 0.0001) and fewer units transfused per patient (WMD: −0.68 [−0.98, −0.39]; Z = 4. 52, P < 0.00001) than did patients in the CSD group. Wound complications, deep vein thrombosis, febrile complications, post-operative hemoglobin days 5–8, drainage volume, and length of hospital stay did not differ significantly between the two types of drainage systems.ConclusionThis meta-analysis suggests that ABTD is a safe and effective method that yields a lower blood transfusion rate and fewer units transfused per patient in TKA compared with CSD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1301-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 84%

The efficacy and safety of autologous blood transfusion drainage in patients undergoing total knee arthroplasty: a meta-analysis of 16 randomized controlled trials

Pan

Hong

Xie

et al. 2016

BMC Musculoskelet Disord

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“…Improving PLOF especially in older adults should be considered prior to LSS to improve surgical outcomes. In addition, clinicians should consider strategies to reduce blood loss and maintain the hemoglobin level within the physiological limits through pharmacological interventions and perioperative blood transfusion [45]. Elevating hemoglobin may help improve surgery outcomes and ultimately reduce LOS.…”

Section: Discussionmentioning

confidence: 99%

Structural equation model analysis of the length-of-hospital stay after lumbar spine surgery

et al. 2015

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Background context Length of hospital stay (LOS) after lumbar spine surgery (LSS) can be affected by many factors. However, few studies have evaluated predictors of LOS, and all have used limited number of variables as predictors. Purpose To identify pre-surgical, surgical, and post-surgical predictors of LOS following LSS. Study Design/Setting Retrospective review of consecutive patients who had LSS at the (Blinded) Hospital from October, 2008 to April, 2012. Patient Sample 593 patients who underwent LSS consisting of laminotomy, laminectomy, or arthrodesis. Outcome Measures Dependent variable: LOS. Multiple pre-surgical, surgical, and post-surgical variables were extracted from patients’ medical records and considered as possible predictors (independent variables) of LOS. Methods Potential predictors that were significantly correlated with LOS were used as indicators to construct three latent factors; pre-surgical, surgical, and post-surgical, which were in turn used to predict LOS in a structural equation model (SEM). Results The average LOS was 4.01±2.73 days. The pre-surgical factor was indicated by age (61.97±14.49 years), prior level of function (60.5% were totally independent), prior hemoglobin level (13.70±1.36 mg/dl), and use of assistive devices (60% were assistive device users). The surgical factor was indicated by severity of illness (50.2% had minor disease severity), presence of complications (1.9%), and stay in an intensive care unit (4.0%). The post-surgical factor was indicated by post-surgical walking distance (166.43±175.75 feet), level of assistance during walking (5.18±0.81 out of 7 points), balance scores (6.18 ±1.82 out of 10 points), and bed mobility and transfer dependency scores (9.81± 1.99 out of 14 points). These three latent factors explained 47% of variation in LOS. Conclusion Post-surgical factors predicted the highest variation in LOS in comparison to pre-surgical and surgical factors and should be taken into consideration for discharge planning. Post-surgical factors are related to the patient's function, modifiable with rehabilitation and can be improved to shorten LOS. Inclusion of more reliable and standardized pre-surgical variables could improve the predictability of the model.

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“…Perioperative anemia is a common phenomenon in elderly patients undergoing hip or knee arthroplasty and hip fracture management [1,2], and anemia in the elderly is an independent risk factor for the decline of physical performance [3] and is associated with a series of deleterious outcomes [4][5][6][7][8][9]. Blood transfusion is necessary for more severe degrees of anemia, and less severe degrees of anemia is often treated with supplemental intravenous or oral iron or recombinant human erythropoietin (rHuEPO) therapy [10].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Iron Supplementation for the Elderly Patients Undergoing Hip or Knee Surgery: A Meta-Analysis of Randomized Controlled Trials

Yang

et al. 2011

Journal of Surgical Research

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Influence of Hemoglobin Levels on Inpatient Rehabilitation Outcomes after Total Knee Arthroplasty

Cited by 45 publications

References 32 publications

The efficacy and safety of autologous blood transfusion drainage in patients undergoing total knee arthroplasty: a meta-analysis of 16 randomized controlled trials

The efficacy and safety of autologous blood transfusion drainage in patients undergoing total knee arthroplasty: a meta-analysis of 16 randomized controlled trials

Structural equation model analysis of the length-of-hospital stay after lumbar spine surgery

Efficacy and Safety of Iron Supplementation for the Elderly Patients Undergoing Hip or Knee Surgery: A Meta-Analysis of Randomized Controlled Trials

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