Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct-Dec;105(4):368504221134429.
doi: 10.1177/00368504221134429.

Factors affecting the need of postoperative blood transfusion in elderly patients with intertrochanteric hip fracture

Myung-Rae Cho  1 , Young-Jae Cho  1 , Suk-Kyoon Song  1
Affiliations

Factors affecting the need of postoperative blood transfusion in elderly patients with intertrochanteric hip fracture

Myung-Rae Cho et al. Sci Prog. 2022 Oct-Dec.

Abstract

Introduction: We investigated the risk factors that increased the frequency of blood transfusions in elderly patients with intertrochanteric hip fractures to determine blood transfusion risk before surgery and to take selective precautionary measures in the group at high risk for transfusion to ensure safe surgery.

Materials and methods: We retrospectively reviewed the electronic medical records of 203 patients who underwent surgical fixation of intertrochanteric hip fractures from January 2015 to December 2020. We hypothesized that patient sex, age, body mass index, preoperative hemoglobin, preoperative platelet count, glomerular filtration rate (GFR), preoperative albumin level, American Society of Anesthesiologist score, intraoperative blood loss, duration of surgery, method of anesthesia, and time from injury to surgery would affect the need for blood transfusion. Student's t-test, Chi-squared test, and the one-way analysis of variance test were used to determine whether differences between variables in the transfusion and non-transfusion groups were significant.

Results: Unstable fractures (P = 0.002), general anesthesia (P = 0.028), lower preoperative hemoglobin levels (P < 0.001), and lower GFRs (P < 0.001) were identified as related to blood transfusions in univariate analysis. In multivariate logistic analysis, the need for allogeneic blood transfusion in unstable fractures was approximately 2.949 times higher than in stable fractures (P = 0.009). The risk in general anesthesia patients was about 2.953 times higher than in spinal anesthesia patients (P = 0.007). In addition, the need for allogeneic blood transfusion increased by about 1.293 times as preoperative hemoglobin levels decreased by 1 g/dL (P = 0.017) and increased by about 1.017 times as the GFR decreased by 1 mL/min/1.7m2 (P = 0.006).

Conclusion: Low preoperative hemoglobin levels, low GFRs, general anesthesia, and unstable fractures in elderly patients with intertrochanteric hip fractures increased the risk of blood transfusion.

Keywords: Hip; blood; fracture; risk factor; transfusion.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of the patients.
Figure 2.
Figure 2.
Radiographic hip images.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Lee Y-K, Kim JW, Lee MHet al.et al.Trend in the age-adjusted incidence of hip fractures in South Korea: systematic review. Clin Orthop Surg 2017; 9: 420. - PMC - PubMed
    1. Foss NB, Kehlet H. Hidden blood loss after surgery for hip fracture. J Bone Joint Surg Br 2006; 88: 1053–1059. - PubMed
    1. Carson J, Altman D, Duff A, et al.Risk of bacterial infection associated with allogeneic blood transfusion among patients undergoing hip fracture repair. Transfusion 1999; 39: 694–700. - PubMed
    1. Nielsen H. Detrimental effects of perioperative blood transfusion. Br J Surg 1995; 82: 582–587. - PubMed
    1. Hill GE, Frawley WH, Griffith KEet al.et al.Allogeneic blood transfusion increases the risk of postoperative bacterial infection: a meta-analysis. J Trauma 2003; 54: 908–914. - PubMed