Preoperative Characteristics Identify Patients with Hip Fractures at Risk of Transfusion
Autor: | John Mac Elwaine, Paul G Murphy, Denis Collins, Mary F Dillon, Paul Nicholson, John Rice |
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Rok vydání: | 2005 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent Blood Loss Surgical Comorbidity Total population Preoperative care Hemoglobins Age Distribution Healthcare delivery Predictive Value of Tests Risk Factors On demand Preoperative Care medicine Humans Blood Transfusion Orthopedics and Sports Medicine Risk factor Aged Aged 80 and over Hip Fractures business.industry General Medicine Middle Aged medicine.disease Surgery Predictive value of tests Orthopedic surgery Female business |
Zdroj: | Clinical Orthopaedics and Related Research. 439:201-206 |
ISSN: | 0009-921X |
DOI: | 10.1097/01.blo.0000173253.59827.7b |
Popis: | Routine cross-matching places substantial demands on limited blood resources. The primary objective of this study was to identify patients with hip fractures at risk of transfusion, which may allow implementation of a more selective cross-matching policy. We also sought to determine the hemoglobin level that triggered a transfusion, the rate of urgent (intraoperative) transfusions, and these patients' characteristics. We reviewed 124 consecutive patients admitted with hip fractures. Patients' clinical and radiologic details, transfusion rates, timing of transfusion, and preoperative and postoperative hemoglobin were reviewed. Older age, low admission hemoglobin, and peritrochanteric fractures were identified as risk factors for transfusion. Eighty-six percent of patients who received transfusions had two or more risk factors, compared with 48% of the total population. The mean hemoglobin that triggered a transfusion was 7.8 g/dL. Although 30% (37/124) of patients received transfusions, only 5% (six of 124) received transfusions intraoperatively, and the majority of these patients (five of six) had at least two risk factors of transfusion. Routine cross-matching for patients with hip fractures requiring surgery can safely be converted to cross-matching on demand in all but high-risk patients. Restrictive cross-matching policies would improve costs in healthcare delivery and prevent unnecessary use of blood resources. |
Databáze: | OpenAIRE |
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