Retrospective high volume comparative study suggests that patients on aspirin could have immediate surgery for hip fractures without significant blood loss

Ohmori, Takao; Toda, Kazukiyo; Kanazawa, Tomoyuki; Tada, Keitaro; Yagata, Yukihisa; Ito, Yasuo

doi:10.1007/s00264-021-04941-6

Cited by 8 publications

(7 citation statements)

References 23 publications

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“…In this study, the rate of blood transfusion was 10.46% (95% CI : 8.23–13.21), which was lower than report of Nikolaou et al (63.47%) [ 6 ], Ohmori et al (32.67%) [ 33 ], and Guo et al (29.7%) [ 5 ] in hip fracture patients. The reason might be that the blood loss continue until several days after surgery [ 9 ], but this study only analyzed the blood transfusions from admission to the time of blood routine test.…”

Section: Discussioncontrasting

confidence: 70%

“…In particular, we also did not obtain the anticoagulant and antiplatelet treatment. Yet, a recent study found antiplatelet treatment did not affect perioperative blood loss in patients with hip fracture [ 33 ]. Second, it was a single-center study, and the sample size was small.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, the fluid volume administered perioperatively was not controlled, and this may affect the calculation of the total blood loss. Likewise, the formula to estimate blood loss does not represent the accurate amount of blood loss [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

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Low serum calcium is associated with perioperative blood loss and transfusion rate in elderly patients with hip fracture: a retrospective study

Wang

Chen

et al. 2021

BMC Musculoskelet Disord

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Background To investigate whether hypocalcemia influenced total blood loss and transfusion rate in elderly patients with hip fracture. Methods From our hip fracture database, patients were consecutively included between January 2014 and December 2020. Serum calcium level was corrected for albumin concentration, and hypocalcaemia was defined as corrected calcium < 2.11 mmol/L. Hemoglobin and hematocrit were obtained on admission day and postoperative day, and blood transfusions were collected. According to the combination formulas of Nadler and Gross, the total blood loss of each patient was calculated. Risk factors were further analyzed by multivariate linear regression. Results A total of 583 consecutive elderly hip fracture patients were finally included (mean age 79.32 ± 8.18 years, 68.61% female). On admission, the mean serum corrected calcium level was 2.17 ± 0.14 mmol/L, and the prevalence of hypocalcemia was 33.11% (95% CI: 29.42–37.02). When comparing patients with normal calcium, hypocalcemia patients exhibited a higher blood transfusion rate (7.69% vs 16.06%, P < 0.05), and significantly larger total blood loss (607.86 ± 497.07 ml vs 719.18 ± 569.98 ml, P < 0.05). Multivariate linear regression analysis showed that male, anemia on admission, time from injury to hospital, intertrochanteric fracture, blood transfusion and hypocalcemia were independently associated with increased total blood loss (P < 0.05). Conclusion Hypocalcemia is common in elderly patients with hip fracture, and significantly associated with more total blood loss and blood transfusion. The other risk factors for increased total blood loss are male, anemia on admission, time from injury to hospital, intertrochanteric fracture, and blood transfusion. Level of evidence Level III, retrospective study.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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Low serum calcium is associated with perioperative blood loss and transfusion rate in elderly patients with hip fracture: a retrospective study

Wang

Chen

et al. 2021

BMC Musculoskelet Disord

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“…One study reports that transfusion rate and intensive care unit (ICU) admissions were higher in a group on ASA with no cessation of therapy compared to a control group after proximal femoral fracture, although there were no other significant findings 1786 . A more recent study in patients with hip fracture compared 114 patients taking ASA at the time of their fracture surgery to 103 propensity score matched controls not taking ASA 1787 , and found that taking ASA did not affect peri-operative blood loss or blood transfusion requirements.…”

Section: - Should Aspirin Be Stopped Pre-operatively In Patients Unde...mentioning

confidence: 99%

“…Ohmori et al's 2020 retrospective cohort of 206 patients evaluated perioperative hidden blood loss and transfusion requirements between propensity score matched hip fracture patients on ASA vs. no antiplatelet medication 1765 . They found no significant difference in perioperative blood loss of 598 mL for patients on ASA versus the control group blood loss of 556 mL (p = 0.14).…”

Section: Greggmentioning

confidence: 99%

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2022

Journal of Bone and Joint Surgery

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Comment on “Retrospective high volume comparative study suggests that patients on aspirin could have immediate surgery for hip fractures without significant blood loss”

Wang

Tong

2021

International Orthopaedics (SICOT)

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Retrospective high volume comparative study suggests that patients on aspirin could have immediate surgery for hip fractures without significant blood loss

Cited by 8 publications

References 23 publications

Low serum calcium is associated with perioperative blood loss and transfusion rate in elderly patients with hip fracture: a retrospective study

Low serum calcium is associated with perioperative blood loss and transfusion rate in elderly patients with hip fracture: a retrospective study

Recommendations from the ICM-VTE: General

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