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J Knee Surg 2021; 34(10): 1120-1125
DOI: 10.1055/s-0040-1701486
Original Article

Association between Type of Anesthesia and Risk of Blood Transfusion Events in Primary Unilateral Total Knee Arthroplasty: A Secondary Analysis Based on a Cohort Study in Singapore

Authors

  • Zhongxin Zhu

    1   The First College of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
    2   Institute of Orthopaedics and Traumatology of Zhejiang Province, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China

  • Peijian Tong

    2   Institute of Orthopaedics and Traumatology of Zhejiang Province, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China
    3   Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China

Funding None.
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Abstract

This study evaluated whether the type of anesthesia independently related to risk of blood transfusion events in patients undergoing total knee arthroplasty (TKA) after adjusting for other covariates. This was a secondary analysis of a retrospective cohort study of patients undergoing primary unilateral TKA in Singapore. The independent variable was the type of anesthesia and the dependent variable was blood transfusion events. A multivariable logistic regression analysis was performed adjusting for variables that might affect the choice of anesthesia or blood transfusion events. Additional analyses examined this association by the subgroup analysis by using stratified multivariate logistic regression models. Of all 2,366 patients undergoing primary unilateral TKA, 120 (5.1%) developed blood transfusion events. Sixty-four (4.1%) of 1,560 patients with regional anesthesia (RA) developed blood transfusion events, compared with 56 (6.9%) of 806 patients with general anesthesia (GA; (p = 0.003). After adjusting for age, sex, preoperative hemoglobin, and other variables, patients who received RA had a decreased risk of blood transfusion events compared with those receiving GA (odds ratio [OR]: 0.53, 95% confidence interval [CI]: 0.35–0.81). This risk further decreased in male (OR: 0.20, 95% CI: 0.07–0.59) and participants whose operation time ≥ 90 minutes (OR: 0.39, 95% CI: 0.19–0.78). Our results indicated that patients receiving primary unilateral TKA who were managed with RA had a significantly decreased risk of blood transfusion events compared with those with GA, especially in male and participants whose operation time ≥ 90 minutes.

Keywords

total knee arthroplasty - regional anesthesia - general anesthesia - blood transfusion

Note

Availability of Data and Materials: Data can be downloaded from “DATADRYAD” database. Dryad data package: Abdullah HR, Sim E, Hao Y, Lin G, Liew GHC, Lamoureux EL, Tan MH (2017). Data from: Association between preoperative anemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-center retrospective study. Dryad Digital Repository. https://doi.org/10.5061/dryad.73250.


Supplementary Material



Publication History

Received: 28 June 2019

Accepted: 27 December 2019

Article published online:
19 February 2020

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