title: Absence of combined effects of anemia and bilateral surgical status on inpatient rehabilitation outcomes following total knee arthroplasty.
abstract: OBJECTIVE
  To examine the effects of anemia on inpatient rehabilitation outcomes following unilateral and bilateral total knee arthroplasty (TKA).
  
  
  METHODS
  This was a multicenter, retrospective study from 15 inpatient rehabilitation facilities. Patients (N = 5421) with very low hematocrit (Hct <30%), low Hct (30-36% women, 30-41% men), or normal Hct (>36% women, 41% men) were included. Inpatient rehabilitation occurred following TKA. Functional independence measure (FIM) scores, length of stay (LOS), itemized hospital charges, discharge destination were main outcomes.
  
  
  RESULTS
  LOS was 13% longer and hospital charges were 12.5-18.0% higher in the very low Hct than remaining groups (p = 0.0001). The FIM score and subscores for walking, stair climbing, bathing, transfers, and dressing changes were comparable for all Hct groups for the overall score. Hct <30% did not correspond to worse outcomes in patients with bilateral surgeries compared with unilateral surgeries; total FIM scores improved 47-53% across all Hct groups, regardless of bilateral surgical status. Discharge to home ranged 92.6-94.7% across all Hct groups (p > 0.05).
  
  
  CONCLUSIONS
  Rehabilitation teams can expect comparable functional improvements and discharge to home in anemic and non-anemic patients with either unilateral or bilateral surgeries without hematologic correction in the rehabilitation setting, but might need an additional day to accomplish these outcomes.
authors.affiliation: Department of Orthopaedics and Rehabilitation, UF&Shands Orthopaedics and Sports Medicine Institute, University of Florida, PO Box 112727, Gainesville, FL 32611, USA. vincehk@ortho.ufl.edu
authors.forename: Heather K
authors.initials: HK
authors.lastname: Vincent
authors.forename: Morrow R
authors.initials: MR
authors.lastname: Omli
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Vincent
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000704:Analysis of Variance; D000740:Anemia / Q000150:complications*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D017722:Hospital Charges; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome