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ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2018, Number 6

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Acta Ortop Mex 2018; 32 (6)

Initial hemoglobin value as a predictor of allogeneic blood transfusion in hip fracture

Torres-Campos A, Floria-Arnal LJ, Muniesa-Herrero MP, Ranera-García M, Osca-Guadalajara M, Castro-Sauras A

Language: Spanish
References: 23
Page: 347-353
PDF size: 215.43 Kb.


ABSTRACT

Introduction: Hip fracture is a cause of major morbidity and mortality and is often associated with high blood transfusion rate, non-complication-free therapy. The objective of the study is to evaluate the factors dependent and independent of the transfusional act, as well as to elaborate an algorithm that allows us to make a decision making based on a statistical model rationalizing the use of blood. Material and methods: Prospective study on 100 patients older than 65 years intervened for hip fracture consecutively. We analyzed demographic data, drug taking, comorbidity, pre- and postoperative analytics, type of fracture and those related to surgery valuing uni- and bivariate determinants of the Transfusional Act to control the possible bias of confusion. Results: Following the application of the bivariate logistic regression model only the HB at the admission (p = 0.04, or = 0.451) and the type of fracture (p = 0.003, or = 5.479) were considered associated with the transfusion act. The value of initial HB generates a ROC curve with an area under the curve of 0.848, acceptable to assess the probability of transfusion. An initial HB value lower of 12.15 g/dl will predict the transfusion with a sensitivity of 80% and a specificity of 85%. Conclusion: The presence of preoperative anemia and extracapsular hip fractures generate a high risk of transfusion need, while it is unlikely in intracapsular fractures without anemia at admission. In our series there is an analytical value that predicts satisfactorily 80% of blood transfusions.


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