The Impact of Blood Management on Length of Stay After Primary Total Knee Arthroplasty
Jad B Monsef, Alejandro G Della Valle, David J Mayman, Robert G Marx, Amar S Ranawat , Friedrich Boettner*
Identifiers and Pagination:Year: 2014
First Page: 108
Last Page: 113
Publisher Id: TOORTHJ-8-108
Article History:Received Date: 19/9/2013
Revision Received Date: 20/3/2014
Acceptance Date: 29/3/2014
Electronic publication date: 16/5/2014
Collection year: 2014
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
The current study investigates the impact of patient factors, surgical factors, and blood management on postoperative length of stay (LOS) in 516 patients who underwent primary total knee arthroplasty. Age, gender, type of anticoagulation, but not body mass index (BMI) were found to be highly significant predictors of an increased LOS. Allogeneic transfusion and the number of allogeneic units significantly increased LOS, whereas donation and/or transfusion of autologous blood did not. Hemoglobin levels preoperatively until 48 hours postoperatively were negatively correlated with LOS. After adjusting for confounding factors through Poisson regression, age (p = 0.001) and allogeneic blood transfusion (p = 0.002) were the most significant determinants of LOS. Avoiding allogeneic blood plays an essential role in reducing the overall length of stay after primary total knee arthroplasty.