Noticewala et al reported a model for predicting the need of blood transfusion after total knee arthroplasty. The authors are from New York-Presbyterian Hospital and Columbia University in New York City.
Patient selection: total knee arthroplasty
Parameters:
(1) age in years
(2) history of anemia
(3) surgical time in minutes
(4) preoperative hemoglobin in g/dL
X =
= (0.06 * (age)) + (1.7 * (points for anemia history)) + (0.02 * (surgical time)) - (0.57 * (hemoglobin)) - 1.02
probability of needing a blood transfusion =
= 1 / (1 + EXP((-1) * X))
Performance:
• The sensitivity was 90% and specificity 53%.
Recommendations to minimize blood loss:
(1) limit the incision to only that which is required to construct an optimal surgical window
(2) cauterize bleeding surfaces in a timely manner
(3) use a cemented TKA
(4) use a tourniquet
(5) make a thorough expeditious closure
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Specialty: Clinical Laboratory, Surgery, orthopedic
