Zhonghua Wai Ke Za Zhi. 2026 Feb 1;64(2):176-181. doi: 10.3760/cma.j.cn112139-20250920-00450.
ABSTRACT
Objective: To explore the perioperative blood loss characteristics of total knee arthroplasty (TKA) in high-altitude residents and identify the relative factors of blood loss. Methods: A retrospective cohort study was conducted, analyzing 400 patients with varus knee osteoarthritis who underwent unilateral TKA from January 2022 to May 2024 at the Second Affiliated Hospital of Army Medical University (Chongqing) and the 953 Hospital of People’s Liberation Army (Shigatse). There were 117 male cases and 283 female cases, with an age of (65.9±7.0) years (range:50 to 80 years). Based on the patients’ altitude of residence, they were divided into a high-altitude group (altitude of 3 800 meters, 200 cases) and a plain group (altitude of 360 meters, 200 cases). The perioperative bleeding conditions (total blood loss, intraoperative overt blood loss, postoperative drainage volume, and hidden blood loss) of the two groups of patients were compared. Through independent sample t test, χ2 test, Pearson correlation analysis and multiple linear regression model, the influencing factors of perioperative blood loss in the plateau group were screened. Results: The intraoperative dominant blood loss of the plateau group was (219.7±108.4) ml, and the postoperative drainage volume was (378.8±144.8) ml. The corresponding values for the plainland group were (150.6±82.3) ml and (171.7±94.7) ml, respectively. The differences between the two groups were statistically significant(t=7.17, P=0.002; t=16.93, P<0.01). The GROSS equation calculated that the total perioperative blood loss of the plateau group was (1 144.9±367.4) ml, and the hidden blood loss was (545.5±299.2) ml, which were significantly higher than those of the plainland group (total blood loss (713.7±257.6) ml, hidden blood loss (387.6±257.4) ml), and the differences were statistically significant (t=13.59, P<0.01; t=5.66, P<0.01). Multivariate linear regression analysis revealed that gender, preoperative activated partial thromboplastin time (APTT), C-reactive protein (CRP), albumin, and bone density T value (all P<0.01) were independent influencing factors for perioperative blood loss in TKA in the plateau group. Conclusions: Perioperative blood loss in TKA for high-altitude residents is significantly higher than in plain areas. Gender, preoperative APTT, CRP, ALB, and bone density T value serve as independent relative factors.
PMID:41667932 | DOI:10.3760/cma.j.cn112139-20250920-00450
