Indications of blood transfusion following total knee replacement at a tertiary care center in central Saudi Arabia

Abstract

Objectives: Total knee replacement (TKR) is an increasingly common procedure worldwide with a continued projected increase in the future. Blood loss following TKR can be relatively high. Globally, the incidence rate of blood transfusion (BT) following TKR has been reported to range between 8% and 18%, whereas a higher estimate reported locally (35%). This study aims to review the indications leading to BT following TKR in a single center. Methods: This is a retrospective study of patients who had BT following primary TKR (171 patients) at a single tertiary center between 2012 and 2016. Patients were categorized into “transfusion indicated” and “transfusion not indicated” groups. Cases were considered indicated if their hemoglobin (Hb) level was ≤8 g/dL, or if there was a drop accompanied by the clinical findings. Patient's demographics, comorbidities, surgery-related data, laboratory findings, blood loss, number of blood units transfused, and their complications were compared between the two groups. Results: Of the study sample, 50 (29.24%) patients were classified as cases without a clear indication for BT. Postoperative Hb was significantly higher in the nonindicated transfusion group (Hb nonindicated 8.54 g/dL, Hb indicated 7.74 g/dL, P