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Transfusion Requirements Following Total Knee Arthroplasty in Patients with Preexisting Blood Dyscrasia.

INTRODUCTION: There is a paucity of studies investigating the incidence of transfusions in various blood dyscrasias after total knee arthroplasty (TKA). The purpose of this study was: 1) to compare the incidence of transfusion post-TKA in patients with and without blood dyscrasia; 2) to compare the post-TKA transfusion incidence of patients with the various individual blood dyscrasias; and 3) to stratify the findings based on gender and age.

MATERIALS AND METHODS: A retrospective review of a Medicare database for patients with preexisting blood dyscrasia was conducted. Patients who underwent TKA and had a blood transfusion were identified by current procedural terminology (CPT) and International Classification of Diseases (ICD-9) ninth revision codes. We compared the incidence of transfusion post-TKA in patients with and without blood dyscrasia as well as transfusion incidence for various individual blood dyscrasias. We stratified these findings based on gender and age of the patients.

RESULTS: There was a higher incidence of postoperative transfusion in patients who had a blood dyscrasia, when compared to those who did not (5.8% vs. 2.7%). The most common type of blood dyscrasia was iron deficiency anemia (81,897). Patients who had aplastic anemia had the highest incidence of transfusion (16.9%). Females were more likely to be anemic (69.1%) compared to males (30.1%); however, the incidence of transfusion was significantly higher in males (6.9%) compared with females (5.5%).

CONCLUSION: The incidence of transfusion was higher in patients with blood dyscrasia. In addition, certain types of blood dyscrasias were associated with higher rates of transfusion. Aplastic anemia had the highest transfusion rate. There was a higher rate of blood transfusions in men when compared to women, although women had a higher prevalence of blood dyscrasias. Future studies need to be conducted to further educate patients and practitioners and optimize TKA blood management care.

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