Correlation of Haemoglobin Levels at 24 Hours and 48 Hours with Need for Transfusion Post Total Knee Replacement (TKR)

Abstract

Objective: This study aims to enhance decision-making for healthcare providers regarding whether to transfuse blood at the 24-hour or 48-hour mark postoperatively.
Study Design: Prospective study
Place and Duration of Study: This study was conducted at the Department of Orthopedics, Shifa International Hospital, Islamabad from August 2024 till January 2025.
Methods: A prospective analysis is conducted on 163 patients, who underwent either unilateral or bilateral TKR at a tertiary care hospital. Of these, 83 patients underwent bilateral TKR, and 80 underwent unilateral TKR. Their Hemoglobin levels were monitored at 24 hours and 48 hours post-surgery mark. The hematocrit levels were also monitored to rule out delusional effects and the need for transfusion was assessed in these patients according to their hemoglobin levels.
Results: In the Unilateral TKR group, out of 80 patients, 40 (50%) transfusions were performed on day 2 when Hb levels were lowest, compared to 12 (15%) on day 1. The 28 patients did not require transfusion at all. In Bilateral TKR, among 83 patients, 36 (43.4%) transfusions were performed on day 2, while only 7 (8.4%) were done on day 1. Remarkably, 40 patients (48.2%) did not require transfusion. The Hematocrit levels were also monitored to rule out delusional effects.
Conclusion: This study highlighted the significance of monitoring Hb levels at 48 Hours, as this appears to be the optimal timeframe for assessing transfusion needs, particularly given the lower Hb levels observed on this day. This is important to assess the likely time of transfusion to prevent patients from undergoing repetitive blood collection for Hb Monitoring.