ArticleBMJ open2017
Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 4 of them syntheses that pooled it.
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Who cites it
57 citing papers in PubMed, 4 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Impact of preoperative anemia on patients undergoing total joint replacement of lower extremity: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2024Pooled it
- Pharmacological interventions for the prevention of bleeding in people undergoing definitive fixation or joint replacement for hip, pelvic and long bone fractures.The Cochrane database of systematic reviews · 2023Pooled it
- The comparative and added prognostic value of biomarkers to the Revised Cardiac Risk Index for preoperative prediction of major adverse cardiac events and all-cause mortality in patients who undergo noncardiac surgery.The Cochrane database of systematic reviews · 2021Pooled it
- Association of iron supplementation with risk of transfusion, hospital length of stay, and mortality in geriatric patients undergoing hip fracture surgeries: a meta-analysis.European geriatric medicine · 2021Pooled it
- A novel nomogram to predict length of stay in patients undergoing pylorus-preserving pancreaticoduodenectomy: A retrospective study.Medicine · 2026Observational
- Postoperative hospital stay and associated factors among adult surgical patients at a specialized hospital in Ethiopia.BMC surgery · 2025Article
- Association between weekday of surgery and length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a secondary analysis based on a retrospective cohort study.Journal of orthopaedic surgery and research · 2025Article
- Prevalence and severity of preoperative anemia, and associated factors among orthopedic patients at public comprehensive referral hospitals, Northwest Ethiopia 2024: multi- center cross-sectional study.Perioperative medicine (London, England) · 2025Article
- Non-linear association between surgical duration and length of hospital stay in primary unilateral total knee arthroplasty: a secondary analysis based on a retrospective cohort study in Singapore.Journal of orthopaedic surgery and research · 2025Article
- Remote Photoplethysmography Technology for Blood Pressure and Hemoglobin Level Assessment in the Preoperative Assessment Setting: Algorithm Development Study.JMIR formative research · 2025Article
- The association between deep vein thrombosis at admission and the time from injury to admission in hip fractures.BMC geriatrics · 2025Article
- The relationship between preoperative anemia and length of hospital stay among patients undergoing orthopedic surgery at a teaching hospital in Ethiopia: a retrospective cohort study.Perioperative medicine (London, England) · 2024Article
- Article
- J-shaped association of operation duration and blood transfusion risk in patients undergoing primary total knee arthroplasty.International orthopaedics · 2024Article
- Navigating anemia and anticoagulation in elderly patients undergoing orthopedic surgery: strategies for preventing complications and implementing treatments.Blood transfusion = Trasfusione del sangue · 2024Review
- Impact of anemia requiring transfusion or erythropoiesis-stimulating agents on new-onset cardiovascular events and mortality after continuous renal replacement therapy.Scientific reports · 2024Article
- Preoperative anemia in older individuals undergoing major abdominal surgery is associated with early postoperative morbidity: a prospective observational study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Observational
- Association between preoperative hemoglobin with length of hospital stay among non-cardiac and non-obstetric surgery patients: a secondary analysis of a retrospective cohort study.Journal of cardiothoracic surgery · 2024Article
- The SingHealth Perioperative and Anesthesia Subject Area Registry (PASAR), a large-scale perioperative data mart and registry.Korean journal of anesthesiology · 2024Article
- Identifying patients at risk of prolonged hospital length of stay after total knee arthroplasty: A real-world study on the creation and validation of a cloud estimator.Biomolecules & biomedicine · 2024Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesStudies in western healthcare settings suggest that preoperative anaemia is associated with poor outcomes after elective orthopaedic surgery. We investigated the prevalence of preoperative anaemia among patients with primary unilateral total knee arthroplasty (TKA) in Singapore and its association with length of hospital stay (LOS), perioperative blood transfusion and hospital readmission rates.
methodsRetrospective cohort study performed in a tertiary academic medical centre in Singapore, involving patients who underwent primary unilateral TKA between January 2013 and June 2014. Demographics, comorbidities, preoperative haemoglobin (Hb) level, LOS and 30-day readmission data were collected. Anaemia was classified according to WHO definition. Prolonged LOS was defined as more than 6 days, which corresponds to >75th centile LOS of the data.
resultsWe analysed 2394 patients. The prevalence of anaemia was 23.7%. 403 patients (16.8%) had mild anaemia and 164 patients (6.8%) had moderate to severe anaemia. Overall mean LOS was 5.4±4.8 days. Based on multivariate logistic regression, preoperative anaemia significantly increased LOS (mild anaemia, adjusted OR (aOR) 1.71, p<0.001; moderate/severe anaemia, aOR 2.29, p<0.001). Similar effects were seen when preoperative anaemia was defined by Hb level below 13 g/dL, regardless of gender. Transfusion proportionately increased prolonged LOS (1 unit: aOR 2.12, p=0.006; 2 or more units: aOR 6.71, p<0.001). Repeat operation during hospital stay, previous cerebrovascular accidents, general anaesthesia and age >70 years were associated with prolonged LOS. Our 30-day related readmission rate was 1.7% (42) cases.
conclusionAnaemia is common among patients undergoing elective TKA in Singapore and is independently associated with prolonged LOS and increased perioperative blood transfusion. We suggest measures to correct anaemia prior to surgery, including the use of non-gender-based Hb cut-off for establishing diagnosis.
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