M. Ali Fazal,Caroline Bagley,Parag Garg.[J].Chin J Traumatol,2018,21(1):16-19. [doi]
Predictors for perioperative blood transfusion in elderly patients with extra capsular hip fractures treated with cephalo-medullary nailingcapsular hip fractures treated with cephalo-medullary nailing
  
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KeyWord: Hip fractures Fracture fixation Cephalo-medullary nailing Blood transfusion
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M. Ali Fazal Royal Free NHS Foundation Trust, The Ridgeway, Enfield, EN2 8JL, United Kingdom 
Caroline Bagley Royal Free NHS Foundation Trust, The Ridgeway, Enfield, EN2 9JL, United Kingdom 
Parag Garg Royal Free NHS Foundation Trust, The Ridgeway, Enfield, EN2 10JL, United Kingdom 
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Abstract:
      Purpose: The aim of our study was to determine predictive factors and requirement for perioperative blood transfusion in elderly patients with extra capsular hip fractures treated with cephalo-medullary device. Methods: Seventy-nine patients with extra capsular hip fractures treated with cephalo-medullary nailing were included in the study. Age, sex, ASA grade, timing of surgery, preoperative and postoperative haemoglobin, length of hospital stay, fracture type, number of units transfused and 30-day mortality were recorded. Results: The mean age was 82.3 years. Forty-seven patients underwent a short nail and 32 patients a long nail; 53.4% patients required blood transfusion postoperatively. Transfusion was required in 71.8% of the long nails (p < 0.05), 65.8% patients above the age of 80 (p < 0.05), 100% of the patients with hemoglobin below 90 g/L and 20 patients with a ASA grade of 3 (p < 0.05). 78.5% patients with A2 fracture and 75% of A3 fractures needed blood transfusion (p > 0.05). Length of hospital stay in non-transfusion group was 13 days and in transfusion group was 19 days (p < 0.05). 55.1% operated within 36 h and 47.6% operated after 36 h of admission needed transfusion (p > 0.05). Thirty-day mortality in patients needing blood transfusion was 5% and in non-transfusion group was 3.7% (p > 0.05). Conclusion: Patient age, ASA grade, preoperative haemoglobin and length of nail are reliable predictors for perioperative blood transfusion in extra capsular hip fractures in elderly patients treated with cephalo-medullary nailing and reinforce a selective transfusion policy.
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