title: Primary total knee arthroplasty allogenic transfusion trends, length of stay, and complications: nationwide inpatient sample 2000-2009.
abstract: Perioperative blood loss leading to blood transfusion continues to be an issue for total knee arthroplasty (TKA) patients. The US Nationwide Inpatient Sample (NIS) was used to determine annual trends in allogenic blood transfusion rates, and effects of transfusion on in-hospital mortality, length of stay (LOS), costs, discharge disposition, and complications of primary TKA patients. TKA patients between 2000 and 2009 were included (n = 4,544,999) and categorized as: (1) those who received a transfusion of allogenic blood, and (2) those who did not. Transfusion rates increased from 7.7% to 12.2%. For both transfused and not transfused groups, mortality rates and mean LOS declined, while total costs increased. Transfused patients were associated with adjusted odds ratios of in-hospital mortality (AOR 1.16; P = 0.184), 0.71 ± 0.01 days longer LOS (P < 0.0001), and incurred ($1777 ± 36; P < 0.0001) higher total costs per admission.
authors: Department of Orthopaedic Surgery, Cleveland Clinic A41, Cleveland, Ohio.
authors: Alison K
authors: AK
authors: Klika
authors: Department of Orthopaedic Surgery, Cleveland Clinic A41, Cleveland, Ohio.
authors: Travis J
authors: TJ
authors: Small
authors: Department of Orthopaedic Surgery, Cleveland Clinic A41, Cleveland, Ohio.
authors: Anas
authors: A
authors: Saleh
authors: Department of Orthopaedic Surgery, Cleveland Clinic A41, Cleveland, Ohio.
authors: Caleb R
authors: CR
authors: Szubski
authors: Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio.
authors: Aiswarya Lekshmi Pillai
authors: AL
authors: Chandran Pillai
authors: Department of Orthopaedic Surgery, Cleveland Clinic A41, Cleveland, Ohio.
authors: Wael K
authors: WK
authors: Barsoum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000191:economics / Q000639:trends*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
keywords: blood loss; complications; nationwide inpatient sample; total knee arthroplasty; transfusion