Impact of Preoperative Anaemia on Blood Transfusion and Clinical Outcomes in Total Knee Arthroplasty: A Retrospective Observational Study

Objective: Preoperative anemia is a common, yet inadequately managed condition in patients undergoing total knee arthroplasty (TKA) and is associated with an increased need for perioperative blood transfusions. However, variability in physicians' transfusion practices remains understudied. This study investigated the influence of preoperative anaemia on transfusion rates and clinical outcomes and examined inter-physician variability in transfusion procedures. Methods: . Demographic characteristics, perioperative variables, laboratory parameters, transfusion data, and postoperative outcomes were recorded. Transfusion rates, complications, and lengths of hospital stay were compared between anemic and non-anemic groups. Inter-physician variability in transfusion decisions was also analysed. Results: < 0.05). Conclusion: Preoperative anemia is common among TKA patients and has been associated with higher transfusion rates. Transfusion was associated with adverse clinical outcomes, including prolonged hospitalisation and higher complication rates. The substantial physician-related variability observed in transfusion practices underscores the need for standardised, evidence-based perioperative transfusion protocols.