ArticleAnnals of the Royal College of Surgeons of England2016
Impact of a blood management protocol on transfusion rates and outcomes following total hip and knee arthroplasty.
Article in Annals of the Royal College of Surgeons of England, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Effectiveness and Safety of Oxidized Regenerated Cellulose for Hemostasis in Joint Arthroplasty: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Routine post-operative full blood count assessment is not necessary in elective hip and knee arthroplasty: A prospective cohort study.Journal of clinical orthopaedics and trauma · 2025Article
- Timing and risk factors of complications following total knee arthroplasty.Annals of medicine and surgery (2012) · 2024Article
- Driving Forces for Outpatient Total Hip and Knee Arthroplasty with Enhanced Recovery After Surgery Protocols: A Narrative Review.Current pain and headache reports · 2024Review
- Factors associated with increased risk of postoperative blood transfusion in patients undergoing total hip arthroplasty at an Irish University Hospital.Irish journal of medical science · 2024Article
- Article
- Extract from the 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery - Patient Blood Management.Blood transfusion = Trasfusione del sangue · 2024Review
- A Decline in Overutilization of Transfusion after Total Knee Arthroplasty Using Pharmacological Agents for Patient Blood Management in South Korea: An Analysis Based on the Korean National Health Insurance Claims Database from 2008 to 2019.Clinics in orthopedic surgery · 2023Article
- Postoperative Hemodynamics of Total Knee Arthroplasty Unaffected by Cementless Approach under Contemporary Patient Blood Management Protocol: A Propensity Score-Matched Study.Journal of clinical medicine · 2023Article
- Preoperative Identification and Management of Anemia in the Colorectal Surgery Patient.Clinics in colon and rectal surgery · 2023Review
- Association of preoperative anemia and increased risk of blood transfusion and length of hospital stay in adults undergoing hip and knee arthroplasty: An observational study in a single tertiary center.Health science reports · 2021Article
- Clinical practice guideline: evidence, recommendations and algorithm for the preoperative optimization of anemia, hyperglycemia and smoking.Canadian journal of surgery. Journal canadien de chirurgie · 2021Review
- Association between intravenous iron therapy and short-term mortality risk in older patients undergoing hip fracture surgery: an observational study.Journal of orthopaedic surgery and research · 2021Observational
- Postoperative Noninvasive Hemoglobin Monitoring Is Useful to Prevent Unnoticed Postoperative Anemia and Inappropriate Blood Transfusion in Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Controlled Trial.Geriatric orthopaedic surgery & rehabilitation · 2021Article
- Is Routine Hemoglobin Monitoring Necessary after Elective Hip and Knee Arthroplasty?Arthroplasty today · 2020Article
- Effectiveness of iron supplementation in the perioperative management of total knee arthroplasty: a systematic review.Knee surgery & related research · 2020Article
- Defining the Most Effective Patient Blood Management Combined with Tranexamic Acid Regime in Primary Uncemented Total Hip Replacement Surgery.Journal of clinical medicine · 2020Article
- The Effect of Intraoperative Ferric Carboxymaltose in Joint Arthroplasty Patients: A Randomized Trial.Journal of clinical medicine · 2019Article
- Hospital cost associated with anemia in elective colorectal surgery: a historical cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2019Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction Preoperative anaemia remains undertreated in the UK despite advice from national agencies to implement blood conservation measures. A local retrospective audit of 717 primary hip/knee replacements in 2008-2009 revealed 25% of patients were anaemic preoperatively. These patients experienced significantly increased transfusion requirements and length of stay. We report the results of a simple and pragmatic blood management protocol in a district general hospital. Methods Since 2010 patients at our institution who are found to be anaemic when listed for hip/knee replacement have been offered iron supplementation and/or erythropoietin depending on haemoglobin and ferritin levels. In this study, postoperative blood transfusions, length of stay and readmissions were assessed retrospectively for all patients undergoing elective primary hip/knee replacement in 2014 and compared with the baseline findings. Results During the 12-month study period, 406 patients were eligible for inclusion and none were excluded. Eighty-nine patients (22%) were anaemic preoperatively and sixty-five received treatment. The transfusion rate fell from the baseline levels of 23.0% and 6.7% to 4.3% and 0.5% for hip and knee replacements respectively (p<0.001). The median length of stay reduced from 6 to 3 days (p<0.001) for both hip and knee replacements. The rate for readmissions within 90 days fell from 13.5% to 8.9% (p<0.05). Conclusions Preoperative anaemia is common in patients listed for hip/knee replacement and it is associated strongly with increased blood transfusion. The introduction of a blood management protocol has led to significant reductions in transfusion and length of stay, sustained over a four-year period. This suggests that improved patient outcomes, conservation of blood stocks and cost savings can be achieved.
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