Risk Factors Analysis and the Establishment of Nomogram Prediction Model of Hidden Blood Loss After Total Hip Arthroplasty for Femoral Neck Fracture in Elderly Women

Abstract

Purpose To investigate the risk factors of increased hidden blood loss (HBL) after total hip arthroplasty (THA) for femoral neck fracture in elderly women and establish the nomogram prediction model for the guidance to reduce HBL in clinic. Patients and Methods A total of 206 elderly female patients with femoral neck fracture who underwent THA in Northern Jiangsu People’s Hospital from January 2019 to November 2021 were included. The demographic and relevant clinical information of the patients were collected. Pearson, independent sample t -test, multiple linear regression and other statistical methods were used for correlation analysis by SPSS 22.0 statistical software. Moreover, the risk factors of postoperative HBL increase in THA patients were obtained and the nomogram prediction model for the guidance to reduce HBL in clinic was established. Results HBL was 626 ± 400 mL, accounting for 72.8% ± 18.4% of the perioperative total blood loss (TBL) (799 ± 411 mL), while blood loss of HGB was 15.1±10.4 g/L. Multiple linear regression analysis showed that HBL was associated with lower age (regression coefficient = −9.271, P = 0.010), operative time (regression coefficient = 2.653, P = 0.004), preoperative blood calcium (<2.25 mmol/L) (regression coefficient = 232.492, P < 0.001), hypertension (regression coefficient = 150.352, P = 0.002) and osteoporosis (regression coefficient = 276.072, P < 0.001). R software was used to construct the nomogram prediction model and draw the ROC curve and calibration curve. The area under the curve (AUC) is 0.92 and the slope of calibration curve is close to 1. Conclusion Based on the five independent risk factors including age, operative time, preoperative blood calcium, hypertension and osteoporosis, the nomogram can predict the risk of HBL after THA for femoral neck fracture in elderly women with favorable differentiation and accuracy.

Hidden blood loss and its possible risk factors in full endoscopic lumbar interbody fusion

“…In both statistical methods, hypertension has become an independent risk factor, which is similar to previous reports [20,21]. As the blood pressure of patients must be controlled in preoperative preparation.…”

Establishment and validation of a nomogram to predict postoperative anemia after total hip arthroplasty

“…This investigation identified intraoperative blood loss and operation time as risk factors for postoperative anemia following THA, which is consistent with previous research findings [ 5 , 22 ]. A prolonged operation time often indicates a more complicated procedure with greater damage, leading to increased bleeding.…”

“…This graphical representation of regression analysis outcomes could assist medical personnel in assessing whether THA patients are at risk for postoperative anemia, and facilitate the implementation of appropriate interventions. Our study expands on previous prediction models by shifting our endpoint from transfusion to anemia, setting it apart from past studies [ 5 , 14 , 15 ].…”

“…However, despite employing various measures, such as proper exposure of the surgical field and the use of intravenous tranexamic acid (TXA), anemia remains a frequent complication of THA, especially in older patients with serious complications [ 3 ]. Related literature suggests that this could be due to several factors, such as sex, age, American Society of Anesthesiologists (ASA) score, and complications [ 4 , 5 ].…”

Hidden Blood Loss and Its Possible Risk Factors in Full Endoscopic Lumbar Interbody Fusion

“…Yin, H. et al [39] believed that blood may be more likely to infiltrate into the muscle interspace in elderly patients due to poorer vascular conditions and muscle wastage. On the other hand, more blood In both statistical methods, hypertension has become an independent risk factor, which is similar to previous reports [36,37], as the blood pressure of patients must be controlled in preoperative preparation. Intraoperative blood pressure is relatively stable with the assistance of anesthesiologists, and the statistical results show that there is no significant correlation between postoperative mean arterial pressure and HBL.…”