Owens et al identified risk factors associated with post-operative blood transfusion for a patient undergoing total knee arthroplasty (TKA). These can help to identify a patient who may benefit from interventions to reduce the need for transfusion. The authors are from the University of Iowa in Iowa City and OrthoCarolina.
Patient selection: status post total knee arthroplasty
Risk factors for transfusion:
(1) history of COPD (OR 1.6)
(2) black race (OR 1.2)
(3) operative time > 2 hours (OR 1.3)
(4) therapy with corticosteroids (OR 1.4)
(5) bleeding disorder (OR 1.4)
(6) partial or total functional dependence (OR 1.6)
(7) ASA status 3 or 4 (OR 1.9 and 2.6 respectively)
(8) age >= 80 years (OR 1.3)
The presence of multiple risk factors may identify a patient who may require a post-operative blood transfusion.
Patients who received a post-operative blood transfusion were at increased risk of having a post-operative complication (pneumonia, urinary tract infection, septic shock, deep vein thrombosis, myocardial infarction, unplanned readmission, reoperation).
