title: Preoperative anaemia is associated with increased allogeneic pack red cell transfusion in revision hip and knee joint arthroplasty: a retrospective analysis of 5387 patients over a 10-year period at a single high volume centre.
abstract: OBJECTIVE
  To estimate the prevalence of preoperative World Health Organization (WHO) defined anaemia in patients presenting for revision hip and knee arthroplasty and its association with transfusion of allogeneic packed red blood cells (PRBC).
  
  
  BACKGROUND
  Studies have mainly investigated the prevalence of preoperative anaemia in primary and not revision hip and knee joint arthroplasty.
  
  
  METHODS
  An analysis of a prospectively collected patient data for 5387 patients having revision hip or knee arthroplasty over a 10-year period at a single high volume centre was conducted. Logistic regression was used to assess whether the presence of WHO defined preoperative anaemia as well as other risk factors were associated with inpatient allogeneic PRBC transfusion.
  
  
  RESULTS
  There were 5387 patients assessed of which 3021 (56·01%) patients had revision total hip replacements and 2366 (43·09%) had revision total knee arthroplasty. Of these patients 1956 (36·03%) had preoperative WHO defined anaemia. A total of 2034 (37·08%) patients received at least one unit of allogeneic PRBC during their primary hospital admission. In the final model preoperative WHO defined anaemia was independently associated with allogeneic PRBC transfusion in hip and knee revision surgery OR 4·042 (4·012-4·072 95% CI) CONCLUSIONS: Preoperative anaemia is common in patients presenting for revision hip and knee arthroplasty and independently associated with transfusion of allogeneic PRBC.
authors.affiliation: The Royal Marsden NHS Foundation Trust, London, UK. rnathan.k@rmh.nhs.uk.|The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK. rnathan.k@rmh.nhs.uk.
authors.forename: R
authors.initials: R
authors.lastname: Kasivisvanathan
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
authors.forename: V
authors.initials: V
authors.lastname: Ramesh
authors.affiliation: The Royal Marsden NHS Foundation Trust, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Rao Baikady
authors.affiliation: The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
authors.forename: S
authors.initials: S
authors.lastname: Nadaraja
mesh_terms: D000368:Aged; D000740:Anemia / Q000453:epidemiology* / Q000628:therapy*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
keywords: anaemia; joint revision arthroplasty; transfusion