Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea.
Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea.
Sci Rep. 2022 Mar 8;12(1):4083. doi: 10.1038/s41598-022-08137-9.
This study aimed to (1) evaluate the preoperative Hb cut-off value for transfusion after unilateral and bilateral staged (1 week apart) TKAs, respectively, and (2) determine whether cause of preoperative anemia can affect transfusion rate after TKA. A total of 951 patients who underwent TKA (unilateral: 605, bilateral staged: 346) from 2016 to 2019 were reviewed retrospectively. Patient demographics, comorbidities, preoperative Hb level, surgery types, and cause of anemia were evaluated as possible risk factors. The cut-off values for preoperative Hb level to reduce transfusion after TKA were evaluated in each surgery type. Preoperative Hb level, surgery type, and cardiac disease were identified as the risk factors for transfusion after TKA, and preoperative Hb levels of 11.8 (AUC 0.88) and 12.8 (AUC 0.76) were the cut-off values for transfusion after unilateral and staged bilateral TKAs, respectively. Although transfusion rate was higher in anemia with iron deficiency (ID) group than anemia without ID group, preoperative Hb level was also lower in anemia with ID group than anemia without ID group. Single use of preoperative Hb level with different cut-offs depending on the surgery types can be useful indicator for preoperative optimization regardless of cause of anemia.
（1）分别评估单侧和双侧分期（间隔 1 周）全膝关节置换术（TKA）后输血的术前 Hb 截止值；（2）确定术前贫血的原因是否会影响 TKA 后的输血率。回顾性分析了 2016 年至 2019 年期间接受 TKA（单侧：605 例，双侧分期：346 例）的 951 例患者。评估了患者的人口统计学、合并症、术前 Hb 水平、手术类型和贫血原因等可能的危险因素。评估了每种手术类型中术前 Hb 水平降低 TKA 后输血的截止值。术前 Hb 水平、手术类型和心脏病被确定为 TKA 后输血的危险因素，单侧和分期双侧 TKA 后输血的术前 Hb 水平截止值分别为 11.8（AUC 0.88）和 12.8（AUC 0.76）。虽然缺铁性贫血（ID）组的输血率高于非 ID 组，但 ID 组的术前 Hb 水平也低于非 ID 组。术前 Hb 水平的单一使用，根据手术类型采用不同的截止值，无论贫血的原因如何，都可以作为术前优化的有用指标。
