{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T05:19:11Z","timestamp":1780118351386,"version":"3.54.0"},"reference-count":48,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,4,20]]},"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Studies in western healthcare settings suggest that preoperative anaemia is associated with poor outcomes after elective orthopaedic surgery. We investigated the prevalence of preoperative anaemia among patients with primary unilateral total knee arthroplasty (TKA) in Singapore and its association with length of hospital stay (LOS), perioperative blood transfusion and hospital readmission rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study performed in a tertiary academic medical centre in Singapore, involving patients who underwent primary unilateral TKA between January 2013 and June 2014. Demographics, comorbidities, preoperative haemoglobin (Hb) level, LOS and 30-day readmission data were collected. Anaemia was classified according to WHO definition. Prolonged LOS was defined as more than 6 days, which corresponds to &gt;75th centile LOS of the data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analysed 2394 patients. The prevalence of anaemia was 23.7%. 403 patients (16.8%) had mild anaemia and 164 patients (6.8%) had moderate to severe anaemia. Overall mean LOS was 5.4\u00b14.8 days. Based on multivariate logistic regression, preoperative anaemia significantly increased LOS (mild anaemia, adjusted OR (aOR) 1.71, p&lt;0.001; moderate\/severe anaemia, aOR 2.29, p&lt;0.001). Similar effects were seen when preoperative anaemia was defined by Hb level below 13\u2009g\/dL, regardless of gender. Transfusion proportionately increased prolonged LOS (1 unit: aOR 2.12, p=0.006; 2 or more units: aOR 6.71, p&lt;0.001). Repeat operation during hospital stay, previous cerebrovascular accidents, general anaesthesia and age &gt;70 years were associated with prolonged LOS. Our 30-day related readmission rate was 1.7% (42) cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Anaemia is common among patients undergoing elective TKA in Singapore and is independently associated with prolonged LOS and increased perioperative blood transfusion. We suggest measures to correct anaemia prior to surgery, including the use of non-gender-based Hb cut-off for establishing diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016403","type":"journal-article","created":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T21:03:55Z","timestamp":1497042235000},"page":"e016403","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":88,"title":["Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1916-0832","authenticated-orcid":false,"given":"Hairil Rizal","family":"Abdullah","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilin Eileen","family":"Sim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Hao","sequence":"additional","affiliation":[{"name":"Health Services Research Unit, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geng Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey Haw Chieh","family":"Liew","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ecosse L","family":"Lamoureux","sequence":"additional","affiliation":[{"name":"Office of Clinical Sciences, DukeNUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mann Hong","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,6,8]]},"reference":[{"key":"2025121605153818000_7.6.e016403.1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu098"},{"key":"2025121605153818000_7.6.e016403.2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.01141"},{"key":"2025121605153818000_7.6.e016403.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-012-1528-1"},{"key":"2025121605153818000_7.6.e016403.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-011-1396-0"},{"key":"2025121605153818000_7.6.e016403.5","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1486-2"},{"key":"2025121605153818000_7.6.e016403.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.07.020"},{"key":"2025121605153818000_7.6.e016403.7","doi-asserted-by":"publisher","DOI":"10.1054\/arth.2003.50030"},{"key":"2025121605153818000_7.6.e016403.8","unstructured":"HCUPnet: a tool for identifying, tracking, and analyzing national hospital statistics. http:\/\/hcupnet.ahrq.gov\/ (accessed 15 Aug 2016)."},{"key":"2025121605153818000_7.6.e016403.9","doi-asserted-by":"publisher","DOI":"10.1007\/s11420-010-9164-1"},{"key":"2025121605153818000_7.6.e016403.10","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1016\/j.arth.2015.05.029","article-title":"Perioperative complications and length of Stay after Revision Total hip and knee arthroplasties: an analysis of the NSQIP database","volume":"30","author":"Liodakis","year":"2015","journal-title":"J Arthroplasty"},{"key":"2025121605153818000_7.6.e016403.11","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/trf.12332","article-title":"Role of preoperative Anemia for risk of transfusion and postoperative morbidity in fast-track hip and knee arthroplasty","volume":"54","author":"Jans","year":"2014","journal-title":"Transfusion"},{"key":"2025121605153818000_7.6.e016403.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2014.12.026"},{"key":"2025121605153818000_7.6.e016403.13","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/j.arth.2015.10.035","article-title":"The Association of Anemia and its severity with cardiac outcomes and Mortality after Total Knee Arthroplasty in Noncardiac Patients","volume":"31","author":"Chamieh","year":"2016","journal-title":"J Arthroplasty"},{"key":"2025121605153818000_7.6.e016403.14","doi-asserted-by":"crossref","unstructured":"Jans \u00d8 , J\u00f8rgensen C , Kehlet H , et al . 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