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Year : 2020  |  Volume : 4  |  Issue : 3  |  Page : 132-135

Indications of blood transfusion following total knee replacement at a tertiary care center in central Saudi Arabia

1 Department of Surgery, Division of Orthopedic Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
2 Department of Family Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
3 Department of Otorhinolaryngology Head and Neck surgery, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
4 College of Medicine, Princess Nora University, Riyadh, Saudi Arabia
5 Department of Population Health, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia

Correspondence Address:
Dr. Ali A Alhandi
Department of Surgery, Division of Orthopedic Surgery, King Abdulaziz Medical City Riyadh, National Guard Health Affairs, Post Box 22490, Riyadh 11426
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmsr.jmsr_43_20

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Objectives: Total knee replacement (TKR) is an increasingly common procedure worldwide with a continued projected increase in the future. Blood loss following TKR can be relatively high. Globally, the incidence rate of blood transfusion (BT) following TKR has been reported to range between 8% and 18%, whereas a higher estimate reported locally (35%). This study aims to review the indications leading to BT following TKR in a single center. Methods: This is a retrospective study of patients who had BT following primary TKR (171 patients) at a single tertiary center between 2012 and 2016. Patients were categorized into “transfusion indicated” and “transfusion not indicated” groups. Cases were considered indicated if their hemoglobin (Hb) level was ≤8 g/dL, or if there was a drop accompanied by the clinical findings. Patient's demographics, comorbidities, surgery-related data, laboratory findings, blood loss, number of blood units transfused, and their complications were compared between the two groups. Results: Of the study sample, 50 (29.24%) patients were classified as cases without a clear indication for BT. Postoperative Hb was significantly higher in the nonindicated transfusion group (Hb nonindicated 8.54 g/dL, Hb indicated 7.74 g/dL, P < 0.001). Similarly, the body mass index (BMI) was significantly higher in the nonindicated group (BMI nonindicated 35.54, BMI indicated 32.49, P = 0.0123). Conclusion: The number of cases with no clear indication for BT following TKR remains relatively high, enforcing hospital-based policies that require the documentation of rationale for BT might help reduce transfusions with no clear reasoning behind them.

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