Review Question - QID 575

Bierbaum et al in 1999 prospectively evaluated the post operative course of 9482 patients undergoing hip or knee replacement. They found low hemoglobin level < 130g/L preoperatively, revision hip, and bilateral knee to be associated with increased frequency of transfusion post op. In a retrospective study of 296 hip and knee replacement patients by Salido et al in 2002, only preoperative hemoglobin levels and weight of the patient were found to be significant factors in determining need for transfusion post operatively. Gender, height, and surgical duration were not found to be signficant factors in the multivariate analysis. Guerin et al in a prospective study of 162 consecutive THA and TKA found preoperative hemoglobin to be the only predictive factor for need of a transfusion. Weight and age were not significant when assessed by multivariate analysis. Thus, all three cited studies agree that the preoperative hemoglobin predicts need for transfusion.