Blood type O increased perioperative blood loss in total knee arthroplasty: a propensity score-based inverse probability of treatment weighting matched analysis

Abstract

Purpose: The aim of this study was to compare total perioperative blood loss in patients undergoing total knee arthroplasty (TKA) in different ABO blood types. Methods: This study was approved by the Institutional Review Board of our hospital (IRB No. 1510) on 2 February 2015. A total of 260 knees undergoing unilateral primary cemented cruciate-retaining TKA for knee osteoarthritis were retrospectively registered. Perioperative total blood loss was calculated for each blood types based on the change in hematocrit from pre- to postoperative day 7, preoperative height and weight. Differences in blood loss among the four ABO blood types were assessed. The association between blood type (O versus others) and total blood loss was further evaluated after adjusting for baseline characteristics through inverse probability of treatment weighting (IPTW). Results: The study population was divided based on the ABO blood type: type O, 87; type A, 82; type B, 54; and type AB, 37. The mean total blood loss was 829 ± 370 ml for type O, 702 ± 384 ml for type A, 574 ± 361 ml for type B, and 528 ± 282 ml for type AB. Patients with blood Type O had significantly higher blood loss than all other blood types. After IPTW adjustment, mean total blood loss remained higher in type O (790 ± 370 ml) compared to other blood types (613 ± 364 ml). Conclusion: These findings suggest that blood type O may be associated with increased perioperative blood loss in TKA.