Blood Orders and Predictors for Hemotransfusion in Elective Femur Fracture Repair Surgery

Abstract

Objective: to estimate the incidence of red blood cell concentrate orders in elective femur fracture repair surgeries and to identify predictors for hemotranfusion. Method: retrospective cohort study conducted with 271 patients submitted to femur fracture repair surgery between July 2013 and July 2016. Surgical and transfusion data were obtained from patient charts and the Transfusion Management System. Association between sociodemographic and clinical variables related to the surgical procedure and the occurrence of red blood cell concentrate transfusion was analyzed using descriptive statistics, the chi-squared test, relative risk, and odds ratio. Multivariate analysis was performed using binomial logistic regression. Results: the incidence of blood orders for patients undergoing femur fracture repair surgery was 87%. Ninety-one (33.6%) patients received red blood cell concentrate transfusions. Even though placing blood orders is recommended, given the possibility of intra- or postoperative transfusions, only 52 (47.2%) blood transfusions occurred in the preoperative period. The variables female sex, low preoperative hemoglobin levels and procedure lasting longer than 120 minutes presented statistical significance (p<0.05) and were considered predictors for hemototransfusion. Conclusion: Perioperative nursing must be aware of the importance of blood orders for all patients undergoing femur fracture repair surgery, including in the preoperative period, with special attention to patients who are female, previously anemic and submitted to long-lasting procedures.

Nursing care in the transfusion of blood components to surgical patients in the perioperative period

“…On the subject, other authors point out that the equipment with a 170μ filter aims to prevent clots and aggregates from reaching the bloodstream [1,15]. This care procedure associated with the inspection of the bag for the presence of air bubbles and consistency [8] can be understood as the interventions: To Check Device Security and To Implement Security Regime [12].…”

“…The performance of nursing professionals in hemotherapy, specifically in the transfusion of blood components, is regulated by Resolution nº 629/2020 of the Federal Nursing Council (COFEN, as per its Portuguese acronym), which attributes to nurses responsibilities that require complex technical-scientific knowledge and delegates to nursing technicians some attributions under the supervision of nurses [6][7]. Accordingly, considering the importance of understanding how nursing care takes place in this area, the study was held in the context of the surgical units of a trauma hospital, keeping in mind that the traumatic injuries that lead to great blood loss are the main cause for the performance of surgical procedures and the use of blood components [8].…”

Analysis of requests for reservation of blood concentrates in patients referred to urgent surgeries in a teaching hospital

“…Based on an estimate that at least 37% of the surgeries referred to the SC did not follow the reservation protocol within the pre-defined period 7 , using a confidence level of 95% and an estimated error of 5%, for an infinite population, the minimum sample value calculated was 348 surgeries. Sampling was performed sequentially, not probabilistic, in order of entry into the SC from the start date of the investigation (March 2020), according to the administrative records of the sector.…”