title: Should We Use Preoperative Epoetin-α in the Mildly Anemic Patient Undergoing Simultaneous Total Knee Arthroplasty?
abstract: Simultaneous knee arthroplasty is associated with significant blood loss. To prevent transfusion, three preoperative doses of epoetin-α were offered to mildly anemic simultaneous knee arthroplasty patients. A retrospective review, using ICD-9 codes, identified twenty patients from 2007-2009. Epoetin-α increased hemoglobin levels preoperatively (12.6 to 13.9, p<0.01). Twenty patients who did not receive epoetin-α were matched to study patients. Study patients were transfused less (55% vs 95%, p=0.012) and had similar inpatient length of stay. The average blood loss without transfusion was 4.6g/dL. The mildly anemic patient is at high-risk for packed red cell transfusion during simultaneous knee arthroplasty. Three preoperative doses of epoetin-α in the mildly anemic patient decreased total transfusions; however, it did not affect inpatient length of stay.
authors.affiliation: Department of Orthopedics, Kingsbrook Jewish Medical Center, Brooklyn, NY 11203, USA.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Delasotta
authors.forename: Fabio
authors.initials: F
authors.lastname: Orozco
authors.forename: S Mehdi
authors.initials: SM
authors.lastname: Jafari
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Blair
authors.forename: Alvin
authors.initials: A
authors.lastname: Ong
keywords: Single stage bilateral total knee arthroplasty; anemia.; degenerative joint disease; epoetin-α; pain; simultaneous total knee arthroplasty; tranexamic acid