Aderinto and Brenkel identified preoperative factors associated with the need for blood transfusion after a unilateral total hip replacement. The authors are from Queen Margaret Hospital in Dunfermline, Scotland.

Risk factors identified on multivariate analysis:

(1) preoperative hemoglobin < 12 g/dL (a mild increase is seen with hemoglobin in the 12-12.9 g/dL range)

(2) body weight < 70 kilograms


Parameters covered by these 2 risk factors:

(1) female gender

(2) older age

(3) lower height and body mass index (BMI)


Additional factors affecting blood transfusion:

(1) bilateral surgery (vs unilateral replacement)

(2) availability of autologous units (a factor seen in the previous section on spinal fusion surgery)


By restricting type and crossmatch to patients with a preoperative hemoglobin < 11 g/dL the number of units crossmatched could be reduced by 78%.


For the implementation I will recommend type and crossmatch if the preoperative hemoglobin is < 12 g/dL or (hemoglobin < 13 g/dL AND weight < 70 kg), else type and screen.

To read more or access our algorithms and calculators, please log in or register.