摘要
The aim of our study was to determine predictive factors and requirement for perioperative blood transfusion in elderly patients with extra capsular hip fractures treated with cephalo-medullary device. Methods： Seventy-nine patients with extra capsular hip fractures treated with cephalo-medullary nailing were included in the study. Age, sex, ASA grade, timing of surgery, preoperative and postoperative haemoglobin, length of hospital stay, fracture type, number of units transfused and 30-day mortality were recorded. Results： The mean age was 82.3 years. Forty-seven patients underwent a short nail and 32 patients a long nail; 53.4% patients required blood transfusion postoperatively. Transfusion was required in 71,8% of the long nails （p 〈 0.05）, 65.8% patients above the age of 80 （p 〈 0.05）, 100% of the patients with hemoglobin below 90 g/L and 20 patients with a ASA grade of 3 （p 〈 0.05）. 78.5% patients with A2 fracture and 75% of A3 fractures needed blood transfusion （p 〉 0.05）. Length of hospital stay in non-transfusion group was 13 days and in transfusion group was 19 days （p 〈 0.05）. 55.1% operated within 36 h and 47,B% operated after 3B h of admission needed transfusion （p 〉 0.05）. Thirty-day mortality in patients needing blood transfusion was 5% and in non-transfusion group was 3.7% （p 〉 0.05）, Conclusion： Patient age, ASA grade, preoperative haemoglobin and length of nail are reliable predictors for perioperative blood transfusion in extra capsular hip fractures in elderly patients treated with cephalo-medullary nailing and reinforce a selective transfusion policy.
