A point score system for predicting the likelihood of blood transfusion after hip or knee arthroplasty

Abstract

The likelihood of a postoperative blood transfusion can be predicted by using this simple point score system. Autologous blood donation can subsequently be targeted to the high-risk patients.

A Randomized Trial of Acute Normovolemic Hemodilution Compared to Preoperative Autologous Blood Donation in Total Knee Arthroplasty

“…A recent report from Canada found that only 4% of patients undergoing unilateral knee arthroplasty required allogeneic transfusion, whereas 31% of patients undergoing bilateral knee arthroplasty received allogeneic blood [31]. This report and our current study supports a conclusion that autologous blood procurement is not necessary for patients undergoing initial, unilateral knee arthroplasty.…”

Bleeding impacting mortality after noncardiac surgery: a protocol to establish diagnostic criteria, estimate prognostic importance, and develop and validate a prediction guide in an international prospective cohort study

“…24 These data suggest that a perioperative bleeding event should not increase the risk of death unless the hemoglobin level goes below 80 g/L or perhaps 70 g/L. Finally, numerous investiga- tors have attempted to predict bleeding requiring perioperative blood transfusion in noncardiac surgery, [25][26][27][28][29][30][31] but those studies were small compared to our study, with samples ranging from 94 to 1875 patients, and were often limited to a single centre and type of surgery.…”

Tranexamic Acid Benefits Total Joint Arthroplasty Patients Regardless of Preoperative Hemoglobin Value

“…Tranexamic acid has been shown to effectively decrease blood loss and postoperative transfusion rates in orthopedic patients without an increase in TEE [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Other studies investigating risk factors for postoperative transfusion found preoperative Hgb to be a significant predictor for subsequent packed red blood cell transfusion [23][24][25][26].…”

“…Many of these investigations demonstrated preoperative Hgb value to be a significant predictor of postoperative transfusion [23][24][25][26]. As such, there are certain preoperative Hgb levels where postoperative transfusion is less likely and the utility of TXA is unknown.…”