Preoperative risk factors for postoperative blood transfusion after hip fracture surgery: establishment of a nomogram

Autor: Xiao Kang Cheng, Fu Cheng Bian, Yong Sheng An
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Blood transfusion
medicine.medical_treatment
Diseases of the musculoskeletal system
Logistic regression
Nomogram
Hip fracture
Fracture Fixation
Internal
Hemoglobins
0302 clinical medicine
Orthopedics and Sports Medicine
Aged
80 and over
Orthopedic surgery
Age Factors
Tranexamic Acid
030220 oncology & carcinogenesis
Calibration
Preoperative Period
Female
Tranexamic acid
Research Article
medicine.drug
medicine.medical_specialty
Anesthesia
General
Risk Assessment
Arthroplasty
03 medical and health sciences
Predictive Value of Tests
medicine
Humans
Risk factor
Pelvic Bones
Aged
Retrospective Studies
Postoperative Care
Receiver operating characteristic
Hip Fractures
business.industry
medicine.disease
Surgery
Nomograms
Logistic Models
ROC Curve
RC925-935
business
030217 neurology & neurosurgery
RD701-811
Zdroj: Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-8 (2021)
Journal of Orthopaedic Surgery and Research
Popis: Background This study aimed to explore the preoperative risk factors related to blood transfusion after hip fracture operations and to establish a nomogram prediction model. The application of this model will likely reduce unnecessary transfusions and avoid wasting blood products. Methods This was a retrospective analysis of all patients undergoing hip fracture surgery from January 2013 to January 2020. Univariate and multivariate logistic regression analyses were used to evaluate the association between preoperative risk factors and blood transfusion after hip fracture operations. Finally, the risk factors obtained from the multivariate regression analysis were used to establish the nomogram model. The validation of the nomogram was assessed by the concordance index (C-index), the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curves. Results A total of 820 patients were included in the present study for evaluation. Multivariate logistic regression analysis demonstrated that low preoperative hemoglobin (Hb), general anesthesia (GA), non-use of tranexamic acid (TXA), and older age were independent risk factors for blood transfusion after hip fracture operation. The C-index of this model was 0.86 (95% CI, 0.83–0.89). Internal validation proved the nomogram model’s adequacy and accuracy, and the results showed that the predicted value agreed well with the actual values. Conclusions A nomogram model was developed based on independent risk factors for blood transfusion after hip fracture surgery. Preoperative intervention can effectively reduce the incidence of blood transfusion after hip fracture operations.
Databáze: OpenAIRE
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