Perioperative blood loss in elderly patients with femoral neck fracture

doi:10.3877/cma.j.issn.1674-0785.2018.02.005

Abstract

Abstract:

Objective

To evaluate the changes in hematocrit (HCT), hemoglobin (HGB), and hidden blood loss in patients with femoral intertrochanteric fracture.

Methods

A retrospective analysis was performed on the clinical data for 36 elderly patients with femoral intertrochanteric fracture who were treated from January 2013 to December 2015. These patients were divide into either a bone-cement type group or a biological type group according to the type of prosthesis used in surgery, and HGB, HCT, and hidden blood loss were compared statistically.

Results

One day preoperatively and 1, 3, 5, and 7 days postoperatively, the HCT and HGB in the bone-cement type and biological type groups were (34.82±4.76) vs (35.76±4.49), (30.56±3.31) vs (30.38±4.75), (29.86±3.57) vs (28.99±3.86), (28.28±2.15) vs (27.46±2.74), and (29.13±2.11) vs (28.63±3.97); and (119.16±14.74) g/L vs (122.56±11.13) g/L, (100.95±10.49) g/L vs (100.14±14.40) g/L, (99.12±11.25)g/L vs (99.70±11.40) g/L, (99.00±6.46) g/L vs (97.17±13.47) g/L, (102.63±6.41) g/L vs (99.30±14.29) g/L, respectively (P>0.05 for all). Both HCT and HGB reached the lowest on day 5 postoperatively in both groups. On days 1, 3, 5, and 7 postoperatively, the hidden blood loss in the bone-cement type and biological type groups was (670.25±358.12) mL vs (703.97±402.84) mL, (692.28±394.18) mL vs (741.75±456.25) mL, (549.16±322.52) mL vs (580.39±305.94) mL, (570.72±350.61) mL vs (624.60±355.60) mL, respectively; there was a significant difference on days 3 and 7 between the two groups (t=-3.28, P=0.011; t=-3.337, P=0.04), but not on days 1 and 7 (P>0.05). The hidden blood loss reached the lowest on day 5 postoperatively in both groups.

Conclusion

In elderly patients with femoral intertrochanteric fracture, perioperative blood loss is greater than that recorded in surgery, and HGB and HCT should be closely monitored in these patients to estimate the hidden blood loss and perioperative blood loss and give corresponding treatment.

Key words: Elderly, Femoral intertrochanteric fracture, Hidden blood loss, Hemoglobin, Hematocrit

Xiaolin Zhao, Xunzhe Tong, Bo Wang, Xiao Du, Bo Yang, Zhilin Liang. Perioperative blood loss in elderly patients with femoral neck fracture[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(02): 85-89.

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Figures/Tables 4

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组别	男/女（例）	年龄（岁）	身高（m）	体质量（kg）	等待手术时间（d）
骨水泥型组	7/14	82.93±8.02	1.64±0.08	59.57±7.23	2.98±1.19
生物型组	6/9	82.83±7.53	1.62±0.07	58.60±8.63	2.53±1.04
t值	?	-0.517	1.206	0.493	2.536
P值	?	0.633	0.294	0.648	0.064

组别	男/女（例）	年龄（岁）	身高（m）	体质量（kg）	等待手术时间（d）
骨水泥型组	7/14	82.93±8.02	1.64±0.08	59.57±7.23	2.98±1.19
生物型组	6/9	82.83±7.53	1.62±0.07	58.60±8.63	2.53±1.04
t值	?	-0.517	1.206	0.493	2.536
P值	?	0.633	0.294	0.648	0.064

组别	例数	术前1 d	术后1 d	术后3 d	术后5 d	术后7 d
骨水泥型组	21	34.82±4.76	30.56±3.31	29.86±3.57	28.28±2.15	29.13±2.11
生物型组	15	35.76±4.49	30.38±4.75	28.99±3.86	27.46±2.74	28.63±3.97
t值	?	-0.262	-0.064	0.168	0.277	0.422
P值	?	0.806	0.952	0.874	0.796	0.695

组别	例数	术前1 d	术后1 d	术后3 d	术后5 d	术后7 d
骨水泥型组	21	34.82±4.76	30.56±3.31	29.86±3.57	28.28±2.15	29.13±2.11
生物型组	15	35.76±4.49	30.38±4.75	28.99±3.86	27.46±2.74	28.63±3.97
t值	?	-0.262	-0.064	0.168	0.277	0.422
P值	?	0.806	0.952	0.874	0.796	0.695

组别	例数	术前1 d	术后1 d	术后3 d	术后5 d	术后7 d
骨水泥型组	21	119.16±14.74	100.95±10.49	99.12±11.25	99.00±6.46	102.63±6.41
生物型组	15	122.56±11.13	100.14±14.40	99.70±11.40	97.17±13.47	99.30±14.29
t值	?	-0.463	0.031	0.014	0.109	0.170
P值	?	0.667	0.977	0.989	0.919	0.874

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