REDUCTION OF BLOOD TRANSFUSION RATES IN UNILATERAL TOTAL KNEE ARTHROPLASTY BY THE INTRODUCTION OF A SIMPLE BLOOD TRANSFUSION PROTOCOL

Abstract

In consecutive patients undergoing unilateral TKA in a single institution, we undertook an audit of blood transfusion practices before and after introduction of a blood transfusion protocol.

Before and after the introduction of the protocol, 393 patients (group I) and 295 patients (group II) respectively were audited. The protocol stated that only patients with preoperative haemoglobin of less than 11 were cross-matched before surgery. The criterion for postoperative transfusion was a postoperative haemoglobin of less than 8.5 or a symptomatic patient with a haemoglobin greater than 8.5. The introduction of the protocol reduced the transfusion rates from 31% in group I to 11.9% in group II (CI 13.1% to 24.9%). The length of stay was reduced from 11.4 to 9.3 days (CI 1.4 to 2.9).

There were no adverse outcomes related to the introduction of the protocol.