Are Allogeneic Transfusions Decreasing in Total Knee Arthroplasty Patients? National Inpatient Sample 2009-2013

Area of Science:

• Orthopedics
• Transfusion Medicine
• Health Economics

Background:

• Allogeneic transfusions are common in total knee arthroplasty (TKA) but linked to adverse events and increased costs.
• Understanding transfusion trends, risk factors, and outcomes is vital for optimizing patient care.

Purpose of the Study:

• To analyze trends in allogeneic blood transfusion use for primary TKA patients between 2009-2013.
• To identify risk factors and adverse events associated with allogeneic transfusions in TKA.
• To evaluate the impact of transfusions on discharge disposition, length-of-stay (LOS), and costs.

Main Methods:

• Analysis of 3,217,056 primary TKA patients from the National Inpatient Sample database (2009-2013).
• Comparison of demographic, clinical, economic, and discharge data between transfused and non-transfused patients.
• Assessment of risk factors, adverse events, discharge disposition, LOS, and costs/charges.

Main Results:

• Allogeneic transfusion incidence decreased significantly from 13.9% to 7.3% (P < .001).
• Most comorbidities increased transfusion risk, except AIDS, metastatic cancer, and peptic ulcer disease.
• Transfusion associated with worse outcomes, higher LOS, increased short-term care discharge, and greater costs.

Conclusions:

• Allogeneic transfusions in TKA are linked to poor outcomes and higher costs.
• Minimizing allogeneic transfusions is essential, necessitating effective blood management strategies.
• Orthopedists must be aware of these risks and management strategies given the rising demand for TKAs.