Predicting Blood Loss in Total Knee and Hip Arthroplasty

Sizer, Stephen C.; Cherian, Jeffrey J.; Elmallah, Randa K.; Pierce, Todd P.; Beaver, Walter B.; Mont, Michael A.

doi:10.1016/j.ocl.2015.06.002

Cited by 58 publications

(49 citation statements)

References 61 publications

(56 reference statements)

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“…), which was consistent with the previously published reports on TKR without IA-TXA application [13–15, 23–27]. …”

Section: Discussionsupporting

confidence: 93%

“…Nonetheless, even with our best knowledge, of using this new technique, the amount of PBL is sometimes high and BT may be required, while these incidences seem to vary in different report studies, as 300–1,300 mL of PBL and 0%–20% of BT [8–13]. Although there have been numerous studies that showed predictors of blood loss and transfusion requirement after TKR (such as age, gender, body mass index, preoperative hemoglobin (Hb) level, use of postoperative anticoagulation, surgical time, and intraoperative blood loss [14, 15]), the local application of tranexamic acid (TXA), which directly controls surgical bleeding, from raw surfaces and small noncoagulated blood vessels, might have different effects on these predicting factors of blood transfusion requirement presented in the previous literatures. Moreover, the risk factors associated with BT or PBL after using IA-TXA application have not yet been studied, and we thought that identifying patients with increased risk of considerable PBL and the need for perioperative BT is an important step toward establishing a better effective blood management strategy [16].…”

Section: Introductionmentioning

confidence: 99%

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Predicting Factors for Allogeneic Blood Transfusion and Excessive Postoperative Blood Loss after Single Low-Dosage Intra-Articular Tranexamic Acid Application in Total Knee Replacement

Sa-ngasoongsong

Wongsak

Kulachote

et al. 2017

BioMed Research International

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Background. Recently, intra-articular tranexamic acid (IA-TXA) application has become a popular method for perioperative blood loss (PBL) reduction in total knee replacement (TKR). Nevertheless, through our knowledge, no previous studies had shown the correlation perioperative factors and the risk of excessive PBL or need of blood transfusion (BT) after IA-TXA. Materials and Methods. A retrospective study was conducted in patients underwent 299 primary TKRs, using IA-TXA, during 2-year period (2013-2014). Patient's characteristic and perioperative data were reviewed and collected. PBL was measured as total hemoglobin loss (THL), estimated total blood loss (ETBL), and drainage volume per kg (DV/kg). Excessive PBL was defined as PBL that exceeded 90th percentile. Results. From multivariate analysis, low preoperative hemoglobin (Hb) level and body mass index (BMI) were the significant predictors of postoperative BT (p < 0.0001 and 0.003, resp.). Excessive THL significant associated with preoperative Hb (p < 0.0001). Excessive ETBL significantly associated with preoperative Hb, height, preoperative range-of-motion, and creatinine clearance (p < 0.05 all). Low BMI and large prosthesis size were the significant predictors of excessive DV/kg (p = 0.0001 and 0.002, resp.). Conclusions. Low preoperative Hb and BMI were the significant risks of postoperative transfusion after TKR with IA-TXA. Moreover, multiple perioperative factors could result in higher PBL.

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“…), which was consistent with the previously published reports on TKR without IA-TXA application [13–15, 23–27]. …”

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Predicting Factors for Allogeneic Blood Transfusion and Excessive Postoperative Blood Loss after Single Low-Dosage Intra-Articular Tranexamic Acid Application in Total Knee Replacement

Sa-ngasoongsong

Wongsak

Kulachote

et al. 2017

BioMed Research International

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“…The purpose of this study was to determine patient and surgical factors associated with blood loss and need for transfusion in a consecutive series of TKA performed by a single surgeon. Our findings are in agreement with several studies that reported how preoperative Hb is significantly associated with blood loss and the need for transfusion (26,(28)(29)(30)(31)(32). In particular, Noticewala et al (26) evaluated the association of 31 factors with blood loss and need for transfusion during TKA.…”

Section: Discussionsupporting

confidence: 93%

Factors that influence blood loss and need for transfusion following total knee arthroplasty

et al. 2017

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“…Sodhi et al reported that the operation time was closely related to LOS [23]. Sizer et al found that elder patients were easier to occur bleeding during operation and had increased complications [24]. Primary disease could affect patients' satisfaction and the LOS [25].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the length of stay in total knee arthroplasty patients with the enhanced recovery after surgery model

Weng

et al. 2019

J Orthop Surg Res

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Objectives: The purpose of this study is to identify the factors that influence the length of stay (LOS) in total knee arthroplasty (TKA) patients with an enhanced recovery after surgery (ERAS) program. Methods: Information from 167 patients (31 males and 136 females, range from 43 years to 88 years old) who underwent the unilateral elective primary TKA from January 2017 to January 2019 were reviewed retrospectively. Factors were analyzed by single-factor variance and multi-factor linear regression. Results: By single-factor variance analysis, American Society of Anesthesiologists (ASA) physical status classification system, pre-operation albumin, pre-operation erythrocyte sedimentation rate (ESR), primary and merge diseases, hidden blood loss, and length of operation were correlated with LOS (P < 0.05). Multi-factor linear regression results suggested that gender, ASA class, pre-operation Alb, and pre-operation ESR were associated with LOS (P < 0.05). Moreover, ASA class 3 (B value 4.84), pre-operation Alb < 30 g/L (B value 18.33), and pre-operation ESR > 15 mmol/h (B value 2.21) could increase the LOS, while males (B value − 3.56) had a shortened LOS. Conclusions: Overall, our research found that female, ASA class 3, pre-operation Alb < 30 g/L, and pre-operation ESR > 15 mmol/h could extend LOS in TKA patients with ERAS.

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Predicting Blood Loss in Total Knee and Hip Arthroplasty

Cited by 58 publications

References 61 publications

Predicting Factors for Allogeneic Blood Transfusion and Excessive Postoperative Blood Loss after Single Low-Dosage Intra-Articular Tranexamic Acid Application in Total Knee Replacement

Predicting Factors for Allogeneic Blood Transfusion and Excessive Postoperative Blood Loss after Single Low-Dosage Intra-Articular Tranexamic Acid Application in Total Knee Replacement

Factors that influence blood loss and need for transfusion following total knee arthroplasty

Factors associated with the length of stay in total knee arthroplasty patients with the enhanced recovery after surgery model

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