Analysis of perioperative blood transfusion risk and short-term prognosis in elderly patients with hip fracture
10.3969/j.issn.1671-8348.2024.22.008
- VernacularTitle:老年髋部骨折患者围手术期输血风险及短期预后分析
- Author:
Daxue ZHANG
1
;
Shiwei YANG
Author Information
1. 安徽医科大学护理学院,合肥 230032;深圳市第二人民医院/深圳大学第一附属医院教学办公室,深圳 518000;深圳市第二人民医院/深圳大学第一附属医院骨科,深圳 518000
- Keywords:
hip fracture;
perioperative blood transfusion;
risk factors;
prognosis
- From:
Chongqing Medicine
2024;53(22):3401-3406
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk of perioperative blood transfusion in elderly patients with hip fracture and its impact on short-term prognosis.Methods The clinical data of elderly patients with hip fracture admitted to the orthopedic department of Shenzhen Municipal Second People's Hospital from January 2021 to November 2022 were collected.The patients were divided into the blood transfusion group and non-blood transfusion group according to whether or not having blood transfusion during perioperative period.The independent influencing factors for perioperative blood transfusion were analyzed by the univariate and multi-factorial logistic regression,and the short-term prognostic differences were compared between the two groups.Results A total of 412 elderly patients with hip fracture were included in the study.There were 257 cases of perioperative blood transfusion(blood transfusion group,62.4％),and the average blood transfusion amount was(4.1±2.52)U.The univariate analysis showed that the age,fracture type,complications(cardiac insuffi-ciency,preoperative pulmonary infection,bronchiectasis),red blood cell count,hemoglobin,red blood cell vol-ume distribution width,albumin,ASA grade,NYHA cardiac function grade,surgical mode,intraoperative blood loss volume and operative time had statistical differences between the blood transfusion group and non-blood transfusion group(P＜0.05).The multivariate logistic analysis showed that preoperative low Hb level,cardiac insufficiency,intraoperative blood loss volume＞200 mL and operative duration＞120 min were the independent risk factors for perioperative blood transfusion in elderly patients with hip fracture.The hospitali-zation and bed rest time in the blood transfusion group were longer than those in the non-blood transfusion group,the hospitalization expenses was higher and the activity of daily living(ADL)score was lower(P＜0.05).Conclusion The preoperative blood transfusion in elderly patients with hip fractures has high risk.Preopera-tive low hemoglobin level,cardiac insufficiency,intraoperative blood loss volume＞200 mL and operative du-ration＞120 min are the independent risk factors for perioperative transfusion in elderly patients with hip fracture and affect the short term prognosis in the patients.
