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dc.contributor.authorKopanidis, Paul-
dc.contributor.authorHardidge, Andrew-
dc.contributor.authorMcNicol, Larry-
dc.contributor.authorTay, Stanley-
dc.contributor.authorMcCall, Peter R-
dc.contributor.authorWeinberg, Laurence-
dc.identifier.citationJournal of Orthopaedic Surgery and Research 2016; 11: 28en_US
dc.description.abstractBackground: Optimisation of blood management in total hip (THA) and knee arthroplasty (TKA) is associated with improved patient outcomes. This study aimed to establish the effectiveness of a perioperative blood management programme in improving postoperative haemoglobin (Hb) and reducing the rate of allogenic blood transfusion. Methods: This retrospective before and after study involves 200 consecutive patients undergoing elective TKA and THA before (Usual Care group) and after (Intervention group) the introduction of a blood management programme in an Australian teaching hospital. Patients in the Intervention group underwent preoperative treatment for anaemia and received intraoperative tranexamic acid (15 mg/kg). The primary outcomes were to compare postoperative Hb levels and the rate of blood transfusion. Secondary outcomes included measurements of total amount of allogenic blood transfused, transfusion-related complications, postoperative complications, need for inpatient rehabilitation and duration of hospital stay. Results: There were no differences between baseline characteristics between groups. The mean (SD) preoperative Hb was higher in the Intervention group compared to that in the Usual Care group: 138.7 (13.9) vs. 133.4 (13.9) g/L, p = 0.008, respectively. The postoperative day 1 Hb, lowest postoperative Hb and discharge Hb were all higher in the Intervention group (p < 0.001). Blood transfusion requirements were lower in the Intervention group compared to the Usual Care group (6 vs. 20 %, p = 0.003). There were no differences in any of the secondary outcomes measured. Patients who were anaemic preoperatively and who underwent Hb optimisation had higher Hb levels postoperatively (odds ratio 5.7; 95 % CI 1.3 to 26.5; p = 0.024). Conclusions: The introduction of a perioperative blood optimisation programme improved postoperative Hb levels and reduced the rate of allogenic blood transfusion.en_US
dc.subjectBlood transfusionen_US
dc.subjectHaemoglobin optimisationen_US
dc.subjectPreoperative anaemiaen_US
dc.subjectTranexamic aciden_US
dc.titlePerioperative blood management programme reduces the use of allogenic blood transfusion in patients undergoing total hip and knee arthroplastyen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleJournal of Orthopaedic Surgery and Researchen_US
dc.identifier.affiliationDepartment of Orthopaedic Surgery, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Surgery, The University of Melbourne, Parkville, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Anaesthesia, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationDepartment of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australiaen_US
dc.identifier.affiliationAnaesthesia Perioperative Pain Medicine Unit, University of Melbourne, Heidelberg, Victoria, Australiaen_US
dc.type.austinJournal Articleen_US
item.openairetypeJournal Article-
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