Scientific Articles
Identify the trends of post-operative haemoglobin level change and risk factors for blood transfusions in surgically managed neck of femur fractures
Authors:
W. Y. M. Abeysekera ,
Colombo South Teaching Hospital, Kalubowila, LK
D. H. B. Ubayawansa,
Colombo South Teaching Hospital, Kalubowila, LK
K. D. G. K. Siriwardane,
Colombo South Teaching Hospital, Kalubowila, LK
M. De Almeida,
Colombo South Teaching Hospital, Kalubowila, LK
M. B. N. Dassanayake
Colombo South Teaching Hospital, Kalubowila, LK
Abstract
Introduction
Neck of femur fracture (NOFF) is a major public health issue and there is a hidden blood loss during the surgery for the NOFF.
Objectives
To identify the trend of post-op anaemia and risk factors for blood transfusions in surgically managed Neck of femur fractures (NOFF).
Materials and methods
A prospective cohort analysis of 69 surgically managed NOFF patients was done for a period of 4 months. Age, sex, comorbidities, delay of admission, delay of surgery, type of fracture, level of the surgeon and diet of the patient were considered as risk factors for blood transfusions (BT). Pre-op and post-op day 1 and 3 Haemoglobin (Hb) and Haematocrit (Hct) values were assessed.
Results
Out of 69 patients who underwent surgery for NOFF, 28.9 % (n=20) received blood transfusions at some point of their management. Among non-transfused patients a significant decrease in Hb in post-op day 1 (mean drop =1.06 [95% CI = (0.807, 1.317) (P < 0.05) and further significant drop from post-op day 1 to 3 (mean drop = 0.77 [95% CI = (0.556, 0.984) (P < 0.05) was noted. In Hct a similar pattern noted recording a 2.93 [95% CI = (2.131, 3.722) (P < 0.05)] mean drop in post-op day 1 and a mean drop of 2.20 [ 95% CI = (1.411, 2.992) (P < 0.05) from postop day 1 to 3. Except for the fracture type (p = 0.02) none of the other factors as, age of the patient (p = 0.93), delay of admission (p = 0.09), delay of surgery (p = 0.16), blood group (p = 0.34), level of the surgeon who performed the surgery (p = 0.51), dietary pattern (p = 0.27) the comorbidities (p = 0.5, 1.0, 1.0) had any significant impact for transfusion.
Conclusion
Hb level continues to drop even on post-operative day 3. Postop Hb drop is partly due to haemodilution and extra capsular fractures has a higher risk of blood transfusion than intracapsular NOFF.
How to Cite:
Abeysekera WYM, Ubayawansa DHB, Siriwardane KDGK, De Almeida M, Dassanayake MBN. Identify the trends of post-operative haemoglobin level change and risk factors for blood transfusions in surgically managed neck of femur fractures. Sri Lanka Journal of Surgery. 2016;34(4):7–10. DOI: http://doi.org/10.4038/sljs.v34i4.8314
Published on
31 Dec 2016.
Peer Reviewed
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