Early surgery within 48 h was associated with reduced perioperative blood loss and red blood cell transfusion requirements in older patients with hip fracture: a retrospective study
Early surgery within 48 h was associated with reduced perioperative blood loss and red blood cell transfusion requirements in older patients with hip fracture: a retrospective study
复制标题
DOI：
10.1007/s41999-023-00834-6
复制
发表时间：
2023-07-12
影响因子：
3.8
通讯作者：
Zhou，Fang
中科院分区：
文献类型：
--
作者：
Su，Shilong;Zhang，Yunqing;Zhou，Fang
目的本研究旨在分析老年髋部骨折患者手术时机与围手术期失血量、红细胞（RBC）输注率、红细胞输血量的关系。方法回顾性研究2020年1月至2022年8月在我院接受手术的老年髋部骨折患者。记录并分析人口统计学、骨折类型、手术类型、受伤至住院时间、手术时机、病史（高血压、糖尿病）、手术持续时间、术中失血量、实验室检查以及术前、术后和围手术期红细胞输注需求。根据入院后48 h内或48 h后的手术治疗情况，将患者分为早期手术组（ES）和延迟手术组（DS）。结果最终纳入243例老年髋部骨折患者。其中，96例（39.51%）患者在入院48小时内接受手术，147例（60.49%）在此时间之后接受手术。 ES组的总失血量（TBL）低于DS组（576.03±265.57 ml vs 699.26±380.58 ml，P=0.003）。 ES组术前红细胞输注率、术前及围术期红细胞输注量均显着低于DS组（15.63% vs 26.53%，P = 0.046；50.00 ± 128.15 ml vs 117.01 ± 225.85 ml， P = 0.004；80.21 ± 196.63 ml vs 144.90 ± 253.52 ml，P = 0.027）。结论老年髋部骨折患者入院48小时内的手术时机与围手术期总失血量和红细胞输血需求的减少有关。
PurposeThe aim of this study was to analyze the relationship between the timing of surgery and perioperative blood loss, red blood cell (RBC) transfusion rate, and RBC transfusion volume in older patients with hip fracture.MethodsFrom January 2020 to August 2022, this retrospective study enrolled older patients with hip fracture who underwent surgery in our hospital. The demographics, fracture type, type of surgery, time from injury to hospital, timing of surgery, medical history (hypertension, diabetes), duration of surgery, intraoperative blood loss, laboratory tests, and preoperative, postoperative and perioperative RBC transfusion requirements were recorded and analyzed. According to the surgical treatment within 48 h or after 48 h after admission, the patients were divided into early surgery group (ES) and delayed surgery group (DS).ResultsA total of 243 older patients with hip fracture were finally included in the study. Among these, 96 patients (39.51%) underwent surgery within 48 h of admission and 147 (60.49%) underwent surgery after this time. Total blood loss (TBL) in the ES group was lower than that in the DS group (576.03 ± 265.57 ml vs 699.26 ± 380.58 ml, P = 0.003). Preoperative RBC transfusion rate, and preoperative and perioperative RBC transfusion volume in the ES group were significantly lower than those in the DS group (15.63% vs 26.53%, P = 0.046; 50.00 ± 128.15 ml vs 117.01 ± 225.85 ml, P = 0.004; 80.21 ± 196.63 ml vs 144.90 ± 253.52 ml, P = 0.027).ConclusionTiming of surgery within 48 h of admission for older patients with hip fracture was associated with reduced the total blood loss and RBC transfusion requirements during the perioperative period.