title: Preoperative evaluation and methods to reduce blood use in orthopedic surgery.
abstract: Major elective orthopedic surgery may be associated with significant blood loss and allogeneic transfusion risk. Identifying patients at risk for allogeneic transfusion is best accomplished with a thorough preoperative evaluation of the patient's hematopoietic system, which, unfortunately, is not always carried out. An evaluation of the hematopoietic system begins with an evaluation of the patient's hemoglobin level a minimum of 30 days before the scheduled surgical procedure. This allows for expedited diagnosis and treatment of underlying comorbidities. An unexplained low level of hemoglobin or a hemoglobin level low enough to increase the patient's allogeneic risk should cause elective surgery to be deferred until an evaluation can be preformed and blood management strategies put in place.
authors.affiliation: The Center for Hip and Knee Surgery, 1199 Hadley Road, Mooresville, IN 46158, USA. em.keating@att.net
authors.forename: E Michael
authors.initials: EM
authors.lastname: Keating
mesh_terms: D001803:Blood Transfusion; D001804:Blood Transfusion, Autologous; D000068817:Epoetin Alfa; D017707:Erythrocyte Transfusion; D004921:Erythropoietin / Q000627:therapeutic use; D006801:Humans; D019637:Orthopedic Procedures; D011994:Recombinant Proteins
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa