Blood use in urgent operations for patients with fractures of the femoral neck

Robbins, John A.; Steingold, R.F.

doi:10.1016/0020-1383(86)90233-0

Cited by 12 publications

(5 citation statements)

References 7 publications

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“…Other studies have also identified low preoperative hemoglobin as a risk factor for transfusion. [12][13][14][15] Our univariate analysis showed that older patients were more likely to receive a blood transfusion, but age was not important in our multivariate analysis, which suggests that other factors explain the same variability in need for transfusion as age but were even more predictive. The average age of patients in our study who received a blood transfusion was 83.1 ± 7.9 years compared with 80.9 ± 9.0 years in patients who did not (p < 0.003).…”

Section: Discussionmentioning

confidence: 65%

Factors affecting transfusion requirement after hip fracture: Can we reduce the need for blood?

et al. 2014

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Background: Hip fractures are common injuries that result in blood loss and frequently require the transfusion of blood products. We sought to identify risk factors leading to increased blood transfusion in patients presenting with hip fractures, especially those factors that are modifiable. Methods:We retrospectively reviewed the cases of all patients who had fixation of their hip fractures between October 2005 and February 2010. The need for transfusion was correlated with potential risk factors, including age, sex, preoperative hemoglobin, fracture type, fixation method and more.Results: A total of 835 patients had fixation of their hip fractures during the study period; 631 met the inclusion criteria and 249 of them (39.5%) were transfused. We found an association between need for blood transfusion and female sex (p = 0.018), lower preoperative hemoglobin (p < 0.001), fracture type (p < 0.001) and fixation method (p < 0.001). Compared with femoral neck fractures, there was a 2.37 times greater risk of blood transfusion in patients with intertrochanteric fractures (p < 0.001) and a 4.03 times greater risk in those with subtrochanteric fractures (p < 0.001). Dynamic hip screw (DHS) fixation decreased the risk of transfusion by about half compared with intramedullary nail or hemiarthroplasty. We found no association with age, delay to operation (p = 0.17) or duration of surgery (p = 0.30). Conclusion:The only modifiable risk factor identified was fixation method. When considering blood transfusion requirements in isolation, we suggest a potential benefit in using a DHS for intertrochanteric and femoral neck fractures amenable to DHS fixation.Contexte : La fracture de la hanche est un traumatisme fréquent, qui cause une perte sanguine et nécessite souvent la transfusion de produits sanguins. Nous avons tenté d'identifier les facteurs de risque associés à une hausse du nombre des transfusions sanguines chez des patients ayant subi une fracture de la hanche, en particulier les facteurs modifiables.Méthodes : Au cours d'une étude rétrospective, on a revu les cas de tous les patients chez qui on avait pratiqué une ostéosynthèse pour une fracture de la hanche survenue entre octobre 2005 et février 2010. La nécessité d'une transfusion sanguine a été associée à d'éventuels facteurs de risque, dont l'âge, le sexe, le taux d'hémoglobine préopéra-toire, le type de fracture, la technique d'ostéosynthèse, et d'autres facteurs encore.Résultats : Au total, 835 patients avaient subi une ostéosynthèse pour fracture de la hanche au cours de la période à l'étude; 631 satisfaisaient les critères d'inclusion à l'étude et parmi eux, 249 (39,5 %) ont reçu une transfusion sanguine. On a observé l'existence d'un lien entre la nécessité d'une transfusion sanguine et le sexe féminin (p = 0,018), une plus faible concentration d'hémoglobine préopératoire (p < 0,001), le type de fracture (p < 0,001) et la technique d'ostéosynthèse (p < 0,001). Par rapport aux fractures du col fémoral, le risque de transfusion sanguine était 2,37 fois plus é...

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Section: Discussionmentioning

confidence: 65%

Factors affecting transfusion requirement after hip fracture: Can we reduce the need for blood?

et al. 2014

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“…There are no previous studies comparing blood loss occurring with individual implants used and all previous studies have examined the group as a whole or subdivided patients based on fracture pattern. 4,5 This study explains the inefficiency of blood ordering for the group as a whole, i.e. all fractured neck of femur patients.…”

Section: Discussionmentioning

confidence: 88%

“…all patients with a fractured neck of femur, or alternatively to patients based on the fracture pattern. 4,5 As the same implant may be used for different fracture patterns, we investigated blood loss in patients undergoing operations for fractured neck of femur based on surgical implant. This study demonstrates that blood loss was dependent on which surgical implant was used.…”

mentioning

confidence: 99%

Blood ordering protocol based on proposed surgical implant in fractured neck of femur patients

Morritt

Morritt²,

Kelley³

et al. 2005

Ann R Coll Surg Engl

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“…Hou et al stated that values of 12.4 g/dl and below pose a risk for ABT [18], while Shokoohi et al reported that the ABT rate was six times higher in patients who were anemic at first admission [19]. In Robbins and Steingold's study, only one of nine patients with a Hg level above 11g/dl needed ABT [24]. Kurdy and Hokan recommended blood preparation for patients with a Hg value below 12 g/dl [25], whereas Adunsky et al suggested that patients with a Hg value above 12g/dl can be operated without blood preparation [3].…”

Section: Discussionmentioning

confidence: 97%

“…Several studies in the literature have suggested that preoperative anemia is a predictive factor for perioperative need for ABT [3,[18][19][20][21][22][23][24][25]. Hou et al stated that values of 12.4 g/dl and below pose a risk for ABT [18], while Shokoohi et al reported that the ABT rate was six times higher in patients who were anemic at first admission [19].…”

Section: Discussionmentioning

confidence: 99%

Geriatrik Kalça Kırıklarında Perioperatif Kan Transfüzyon İhtiyacına Etki Eden Faktörler

Kavak

Günay

2022

Osmangazi̇ Journal of Medicine

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Kalça kırıkları geriatrik hastalarda hastaneye yatışların önemli bir nedenidir. Allojenik kan transfüzyonu (AKT) hasta sağlığını etkiler ve ayrıca ekonomik etkileri vardır. Bu nedenle, hasta sonuçlarını iyileştirmek ve kaynak kullanımını optimize etmek için kan yönetimi hakkında daha fazla veriye ihtiyaç vardır. Bu çalışmada birincil amacımız geriatrik kalça kırıkları sonrası AKT ihtiyacını etkileyen prediktif faktörleri belirlemekti.Yöntemler: Kliniğimizde 2011-2021 yılları arasında cerrahi olarak tedavi edilen toplam 596 kalça kırığı hastası analiz edildi. Yaş, cinsiyet, kırık tipi, ASA skoru, cerrahi gecikme süresi, anestezi tipi, ameliyat tipi, antiagregan veya antikoagülan kullanımı, komplikasyonlar ve başvuru anındaki hemoglobin (Hg), hematokrit (Hct), kreatinin ve INR değerleri belirlendi. Risk faktörlerini belirlemek için ikili lojistik regresyon kullanıldı. Uygun kesme noktasını belirlemek için ROC eğrisi kullanıldı. AKT uygulanan hastaların başvuru anında ortalama Hg değeri 10,6±1,2 g/dl iken (p<0,001), ortalama Hct değeri %31,6±3,7 (p<0,001) ve ortalama kreatinin değeri; 1,25±0,88mg/dl (p=0,007). Regresyon analizi sonuçları, preoperatif Hg seviyesinin (p<0,001, OR:0.113, CI:0.068-0.190) ve preoperatif Hct seviyesinin (p=0.016,OR:0.841, CI:0.730-0.968) AKT için prediktif faktörler olduğunu gösterdi. ROC analizi, preoperatif Hg için ≤11,9 g/dl ve preoperatif Hct için ≤35.5'lik bir cut-off değerinin bulunduğunu gösterdi. Kan transfüzyonu ihtiyacını belirleyen ana faktörler başvuru anındaki Hg ve Hct değerleridir. ≤11,9 g/dl'lik bir Hg seviyesi ve ≤35.5'lik bir Hct seviyesi, cut-off değeri olarak güvenle kullanılabilir.

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Blood use in urgent operations for patients with fractures of the femoral neck

Cited by 12 publications

References 7 publications

Factors affecting transfusion requirement after hip fracture: Can we reduce the need for blood?

Factors affecting transfusion requirement after hip fracture: Can we reduce the need for blood?

Blood ordering protocol based on proposed surgical implant in fractured neck of femur patients

Geriatrik Kalça Kırıklarında Perioperatif Kan Transfüzyon İhtiyacına Etki Eden Faktörler

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