The factors that affect blood loss in intertrochanteric fractures treated with proximal femoral nail in the elderly

Tuzun, Harun Yasin; Bilekli, Ahmet Burak; Erşen, Ömer

doi:10.1007/s00068-021-01670-8

Cited by 8 publications

(7 citation statements)

References 35 publications

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“…The surgery duration influenced the risk of blood transfusion in patients who were treated for eFNF ( p < 0.05). This was in contrast with the results reported in the literature [ 35 ]. The correlation between the two parameters remains controversial.…”

Section: Discussioncontrasting

confidence: 99%

“…To determine the patients who were at high risk of perioperative anemia and to avoid unnecessary blood transfusions, several assessment parameters were proposed [ 15 , 17 , 35 , 36 , 37 ]. Lower preoperative Hb levels were found in patients who needed a blood transfusion compared to the other cohort.…”

Section: Discussionmentioning

confidence: 99%

“…However, hip-fracture surgery within 48 h of admission is associated with better outcomes and is moderately recommended by the AAOS [ 8 ], although limited evidence supports not delaying hip-fracture surgery for patients who are taking aspirin and/or clopidogrel [ 8 ]. One of the most widespread motivations for delaying surgery in patients who are affected by extracapsular femoral fractures is an ongoing anticoagulant treatment that is considered to cause extra blood loss due to impaired platelet function [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Blood-Transfusion Risk Factors after Intramedullary Nailing for Extracapsular Femoral Neck Fracture in Elderly Patients

Testa

Montemagno

Vescio

et al. 2023

JFMK

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Background: Extracapsular femoral neck fractures (eFNF) are the third most common type of fracture in traumatology. Intramedullary nailing (IMN) is one of the most frequently used ortho-pedic treatments for eFNF. Blood loss is one of the main complications of this treatment. This study aimed to identify and evaluate the perioperative risk factors that lead to blood transfusion in frail patients with eFNF who undergo IMN. Methods: From July 2020 to December 2020, 170 eFNF-affected patients who were treated with IMN were enrolled and divided into two groups according to blood transfusion: NBT (71 patients who did not need a blood transfusion), and BT (72 patients who needed blood transfusion). Gender, age, BMI, pre-operative hemoglobin levels, in-ternational normalized ratio (INR) level, number of blood units transfused, length of hospital stay, surgery duration, type of anesthesia, pre-operative ASA score, Charlson Comorbidity Index, and mortality rate were assessed. Results: Cohorts differed only for pre-operatively Hb and surgery time (p < 0.05). Conclusion: Patients who have a lower preoperative Hb level and longer surgery time have a high blood-transfusion risk and should be closely followed peri-operatively.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Blood-Transfusion Risk Factors after Intramedullary Nailing for Extracapsular Femoral Neck Fracture in Elderly Patients

Testa

Montemagno

Vescio

et al. 2023

JFMK

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“…Duration of the surgery bore no correlation with the postoperative level of hemoglobin, which is consistent with other studies and diminishes the in uence of surgeon bias [27].…”

Section: Discussionsupporting

confidence: 91%

“…Much attention has been drawn to divergence between blood loss in stable and unstable PTFs groups. Previous studies have documented considerably more bleeding associated with AO31-A2.2 -AO31-A3.3 types, which are generally considered unstable [10,24,26,27]. This research, unlike others, reveals intrastable-group disproportions in terms of surgery-associated.…”

Section: Discussionmentioning

confidence: 42%

Perioperative blood loss factors associated with decreased level of postoperative hemoglobin in stable femoral pertrochanteric fracture groups treated with PFNA.

Juszczak

Broniatowska

Pardała

2022

Preprint

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Aim : The purpose of this analysis was to compare simple pertrochanteric fractures (PTFs) AO31-A1.2 and PTFs with the detachment of lesser trochanter AO31-A1.3 along with the risk factors of perioperative blood loss in terms of their impact on postoperative level of hemoglobin. Methods : This study analysed the clinical data of 334 unilateral, stable PTFs classified as AO31-A1.2 (205 cases) and AO31-A1.3 (129 cases) treated with proximal femoral nail antirotation (PFNA). First postoperative level of hemoglobin and hemoglobin drop (difference between first on admission to hospital and first postoperative hemoglobin levels) were chosen as the principal outcome. Analyzed patients were not transfused between hemoglobin measurements. Multivariate linear regression analysis was performed to study perioperative blood loss risk factors in patients undergoing surgery. Results : Pertrochanteric fractures with the detachment of lesser trochanter (AO31-A1.3) are associated with both greater hemoglobin drop (p=0.011) and lower postoperative hemoglobin level (p=0.078). AO31-A1.3 type of fracture is also correlated with greater risk of postoperative blood transfusion (p=0.038). Female were associated with lower postoperative hemoglobin than men irrespective of the type of fracture (9.31 g/dl vs 10.1 g/dl; p<0.0001). Multi linear regression analysis showed that age, gender, type of fracture, fracture gap displacement, preoperative level of hemoglobin and angle of the fracture gap significantly affect postoperative level of hemoglobin. Conclusion: Despite being recognized as stable PTF with the detachment of lesser trochanter (AO31-A1.3) is burdened with greater risk of postoperative anemia and blood transfusion than simple PTF (AO31-A1.2). Fracture gap displacement and angle of fracture gap are useful predictors for lower level of postoperative hemoglobin.

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Association between fracture type and the risk of bleeding in intertrochanteric femur fractures

Doğan¹,

Yıldırım²,

Palıt³

2022

Journal of Orthopaedics

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The factors that affect blood loss in intertrochanteric fractures treated with proximal femoral nail in the elderly

Cited by 8 publications

References 35 publications

Blood-Transfusion Risk Factors after Intramedullary Nailing for Extracapsular Femoral Neck Fracture in Elderly Patients

Blood-Transfusion Risk Factors after Intramedullary Nailing for Extracapsular Femoral Neck Fracture in Elderly Patients

Perioperative blood loss factors associated with decreased level of postoperative hemoglobin in stable femoral pertrochanteric fracture groups treated with PFNA.

Association between fracture type and the risk of bleeding in intertrochanteric femur fractures

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