title: Factors leading to blood transfusion among Chinese patients undergoing total knee replacements: a retrospective study.
abstract: OBJECTIVE
  To investigate the risk factors leading to blood transfusion among Chinese patients undergoing total knee replacement.
  
  
  METHODS
  From July 2001 to June 2002, a total of 128 primary total knee replacements were performed in 83 Chinese patients (38 unilateral and 45 one-stage sequential bilateral). No pharmaceutical prophylaxis against deep vein thrombosis was used. The risk factors leading to allogenic blood transfusion were analysed.
  
  
  RESULTS
  The important predictive factors for postoperative blood transfusion were preoperative haemoglobin level (p=0.005), intra-operative blood loss (p<0.001), and bilateral total knee replacements (p<0.001).
  
  
  CONCLUSIONS
  To reduce the need of allogenic blood transfusion, we suggest administering erythropoietin or iron supplements to increase the haemoglobin level for patients undergoing total knee replacement. Routine use of intra-operative blood salvage can be considered for patients undergoing one-stage bilateral total knee replacement. Use of a postoperative blood salvage system is recommended for surgeries that may result in major intra-operative blood loss.
authors.affiliation: Department of Orthopaedics and Traumatology, University of Hong Kong, Queen Mary Hospital, Hong Kong. peterwpy@hkucc.hku.hk
authors.forename: W P
authors.initials: WP
authors.lastname: Yau
authors.forename: W M
authors.initials: WM
authors.lastname: Tang
authors.forename: T P
authors.initials: TP
authors.lastname: Ng
authors.forename: K Y
authors.initials: KY
authors.lastname: Chiu
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006723:Hong Kong; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006454:Hemoglobins