Effect Of Blood Transfusion On Postoperative Complications In Patients With Total Knee Arthroplasty And Analysis Of Related Factors

Objective To study the effect of blood transfusion on postoperative complications in patients with total knee arthroplasty(TKA)and analyse the effected factors of perioperative blood transfusion during TKA.Methods we collected the patients with selective unilateral TKA under general anesthesia in the Ningxia Medical University from January 2015 to December 2018.A total of912 patients with older than 18 years old and ASA grade II to III were enrolled.According to whether the patients received blood transfusion,they were divided into blood transfusion group(T group,n=231)and non transfusion group(NT group,n=683).The main outcome measures were the incidence of postoperative complications between the two groups,the secondary outcome measure was the length of hospital stay,and the allogeneic blood transfusion of TKA was taken as dependent variables for univariate analysis.Multivariate logistic regression analysis was used to further confirm the effected factors of perioperative blood transfusion during TKA.Results A total of 912 patients were selected,213 patients received allogeneic transfusion during TKA,and the incidence of allogeneic transfusion was 25.3%.A total of 87 patients had postoperative complications of TKA,of which 3 patients had two kinds of postoperative complications,and the other patients had a single complication,so a total of 90 cases of TKA postoperative complications were observed,including 61 cases of surgical area infection(58 cases of superficial incision infection,1 case of deep incision infection,2 cases of organ(lacuna)infection),10 cases of pulmonary infection,18 cases of lower extremity venous thrombosis(17 cases of intramuscular venous thrombosis,1 case of deep venous thrombosis)and 1 case of allergic reaction.The incidence of overall postoperative complications,surgical area infection and pulmonary infection in the blood transfusion group was higher than that in the non blood transfusion group(P<0.05),but there was no significant difference in the incidence of venous thrombosis and allergic reaction between the two groups,the length of hospital stay in blood transfusion group was longer than that in non blood transfusion group;Univariate analysis of risk factors of allogeneic blood transfusion during TKA showed that there were significant differences in gender,preoperative prothrombin time(PT),preoperative and postoperative hemoglobin,preoperative plasma albumin,intraoperative blood loss and postoperative drainage between the two groups(P<0.05);Multivariate logistic regression analysis showed that preoperative anemia [P<0.001,OR=7.754,95% CI(3.492,17.218)],preoperative hypoproteinemia [P=0.009,OR=2.146,95% CI(1.214,3.797)],intraoperative blood loss [P<0.001,OR=1.006,95% CI(1.005,1.007)],postoperative anemia[P=0.003,OR=1.745,95% CI(1.208,2.520)] were the effected factors of allogeneic blood transfusion during TKA.Conclusion1.In patients with selective unilateral total knee arthroplasty under general anesthesia,perioperative allogeneic blood transfusion can increase the incidence of postoperative complications and prolong the length of hospital stay.2.In patients with selective unilateral total knee arthroplasty under general anesthesia,preoperative anemia,preoperative hypoproteinemia,intraoperative blood loss and postoperative anemia are effected factors of allogeneic blood transfusion during TKA.