[Perioperative risk factors associated with allogeneic blood transfusion in patients with hip fracture surgery]

Rev Med Inst Mex Seguro Soc. 2015 Jul-Aug;53(4):406-13.
[Article in Spanish]

Abstract

Background: The aim of this article is to identify risk factors associated with allogeneic blood transfusion (ABT) in patients undergoing hip surgery during 2008-2009, at a General Hospital, in Yucatán, Mexico.

Methods: Data of patients who received at least one package of allogeneic blood either before, during, or after hip surgery, (cases, n = 118), was compared against that of patients having the same type of surgery, but not transfused with an ABT (controls, n =138). Logistic regression analysis was carried on in estimating associations. Odd Ratios (OR) and 95 % confidence intervals (95 % CI), were applied when appropriate.

Results: Bleeding grater than or equal to 400 ml during surgery (vs < 400 ml, OR 5.68, 95% CI 2.5-12.9, p = 0.007), and having pre surgical hemoglobin (Hb) concentration < 11 g/dL (vs = 11 g/dL, OR 2.86, 95% CI 1.5-5.6; p = 0.001) were both, associated with ABT. Duration of surgery, the femoral segment involved, the surgical procedure and the postsurgical Hb, were all excluded.

Conclusion: Bleeding grater than or equal to 400 ml during surgery and having pre surgical Hb concentration < 11 g/dL were both, associated with increased risk of receiving an ABT.

Introducción: el objetivo es identificar los factores de riesgo asociados a la hemotransfusión alogénica en pacientes con cirugía de cadera realizada en un hospital general citadino, durante 2008 y 2009. Métodos: fueron considerados como casos 118 pacientes que recibieron sangre alogénica en el pre, el trans o en el postquirúrgico inmediato, y como controles 138 pacientes que tuvieron el mismo tipo de cirugía, pero no fueron hemotransfundidos. La relación entre variables se investigó utilizando un modelo de regresión logística del que se obtuvieron la razón de momios (RM) y los intervalos de confianza (IC) de 95 %. Resultados: se identificaron como factores de riesgo: el sangrado transquirúrgico mayor o igual a 400 ml (frente a < 400 ml, RM 5.68, IC 95 % 2.5 a 12.9, p = 0.007) y la concentración prequirúrgica de hemoglobina < 11 g/dL (frente a = 11 g/dL, RM 2.86, IC 95 % 1.5 a 5.6; p = 0.001); pero no la duración de la cirugía, el segmento femoral intervenido, la técnica quirúrgica ni la Hb postquirúrgica. Conclusiones: el sangrado transquirúrgico mayor o igual a 400 ml y la Hb prequirúrgica < 11 g/dL incrementaron el riesgo de hemotransfusión alogénica.

Keywords: Blood transfusion; Hip fractures; Risk factors.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Blood Loss, Surgical
  • Blood Transfusion / statistics & numerical data*
  • Case-Control Studies
  • Female
  • Fracture Fixation*
  • Hemoglobins / metabolism
  • Hip Fractures / blood
  • Hip Fractures / surgery*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Preoperative Period
  • Risk Factors

Substances

  • Biomarkers
  • Hemoglobins