Investigation of perioperative blood loss of femoral shaft fractures treated with intramedullary nail or locking compression plate
| Autor: | Ying Chen, Yurun Yang, Xiaodong Xu, Huan Yang, Qianzheng Zhu, Xingzuo Chen, Peng Lin, Liqiang Wang |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Blood transfusion Anemia medicine.medical_treatment Blood Loss Surgical Bone Nails Hematocrit law.invention Intramedullary rod 03 medical and health sciences 0302 clinical medicine law medicine Humans Retrospective Studies General Environmental Science Fixation (histology) 030222 orthopedics medicine.diagnostic_test business.industry 030208 emergency & critical care medicine Retrospective cohort study Perioperative medicine.disease Fracture Fixation Intramedullary Surgery medicine.anatomical_structure Nail (anatomy) General Earth and Planetary Sciences business Bone Plates Femoral Fractures |
| Zdroj: | Injury. 52:1891-1896 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2021.04.018 |
| Popis: | Femoral shaft fractures (FSFs) are associated with significant blood loss, resulting in anemia and hemorrhagic shock. However, there has been limited data for the blood loss of FSFs during the whole perioperative period. Our primary aim is to quantify the blood loss associated with FSFs treated with intramedullary nail or locking compression plate fixation, as well as to identify the relative affecting factors for perioperative hidden blood loss (HBL).131 consecutive patients with FSFs were enrolled in the retrospective study between January 2009 and January 2020, including 90 cases for intramedullary nail (Nail group) and 41 cases for locking compression plate fixation (Plate group). Demographics and perioperative data were collected and analyzed. Total blood loss (TBL), visible blood loss (VBL), HBL, and percentage of HBL (PHBL) were calculated based on hematocrit (Hct) changes.There was a large drop of hemoglobin (Hb) during the perioperative time. Of all 131 patients, the average HBL was 1445.5 ± 443.2 mL, accounting for 78.7% of TBL (1815.1 ± 446.3 mL). TBL and HBL in Nail group were 1886.1 ± 438.6 mL and 1546.0 ± 424.7 mL; while TBL and HBL in Plate group were 1659.5 ± 427.9 mL and 1225.1 ± 405.7 mL. The differences between the two groups were statistically significant (p = 0.007, p0.001, respectively). Besides, statistical significance (p0.05, p0.05, respectively) was also reported in HBL between Type-A and Type-C, and between Type-B and Type-C (1395.8 ± 444.8 mL vs. 1651.6 ± 495.7 mL; and 1411.2 ± 383.4 mL vs. 1651.6 ± 495.7 mL, respectively).Patients of FSFs had significant TBL and HBL, the amount of which was much larger than that observed intra-operatively. Moreover, two readily available preoperative factors for nail fixation and Type-C were associated with a higher likelihood of more HBL. Therefore, it was argued that regular perioperative monitoring and timely blood transfusion were crucially important for patients to avoid possible risks of anemia and facilitate recovery. |
| Databáze: | OpenAIRE |
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