Factors leading to blood transfusion among Chinese patients undergoing total knee replacements: a retrospective study.

PURPOSE To investigate the risk factors leading to blood transfusion among Chinese patients undergoing total knee replacement. METHODS From July 2001 to June 2002, a total of 128 primary total knee replacements were performed in 83 Chinese patients (38 unilateral and 45 one-stage sequential bilateral). No pharmaceutical prophylaxis against deep vein thrombosis was used. The risk factors leading to allogenic blood transfusion were analysed. RESULTS The important predictive factors for postoperative blood transfusion were preoperative haemoglobin level (p=0.005), intra-operative blood loss (p<0.001), and bilateral total knee replacements (p<0.001). CONCLUSION To reduce the need of allogenic blood transfusion, we suggest administering erythropoietin or iron supplements to increase the haemoglobin level for patients undergoing total knee replacement. Routine use of intra-operative blood salvage can be considered for patients undergoing one-stage bilateral total knee replacement. Use of a postoperative blood salvage system is recommended for surgeries that may result in major intra-operative blood loss.