Jai Hyung Park; Hwa Jae Jung; Hun Kyu Shin; Eugene Kim; Se-Jin Park; Taeg Su Ko; Jong-Hyon Park

doi:10.12671/jkfs.2015.28.1.53

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Original Article
Perioperative Blood Loss in Intramedullary Hip Screw for Intertrochanteric Fracture: Analysis of Risk Factors: Jai Hyung Park, M.D., Ph.D., Hwa Jae Jung, M.D., Ph.D., Hun Kyu Shin, M.D., Ph.D., Eugene Kim, M.D., Ph.D., Se-Jin Park, M.D., Ph.D., Taeg Su Ko, M.D., Jong-Hyon Park, M.D.; Journal of the Korean Fracture Society 2015;28(1):53-58.
DOI: https://doi.org/10.12671/jkfs.2015.28.1.53
Published online: January 20, 2015

Department of Orthopaedic Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address reprint requests to: Jai Hyung Park, M.D., Ph.D. Department of Orthopaedic Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 110-746, Korea. Tel: 82-2-2001-2168, Fax: 82-2-2001-2176, jaihyung.park@samsung.com

• Received: October 26, 2014 • Revised: November 26, 2014 • Accepted: December 24, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
NOTES
REFERENCES

Abstract

Purpose
We compared visible blood loss and calculated blood loss after intramedullary fixation in intertrochanteric fracture, and evaluated correlation between blood loss and its risk factors.
Materials and Methods
A total of 256 patients who underwent closed reduction and intramedullary fixation in femoral intertrochanteric fracture between 2004 and 2013 were enrolled in this study. The total blood loss was calculated using the formula reported by Mercuiali and Brecher. We analyzed several factors, including fracture pattern (according to Evans classification), gender, age, body mass index (BMI), anesthesia method, cardiovascular and cerebrovascular disease, preoperative anemia, American Society of Anesthesiologists (ASA) score and use of antithrombotic agents.
Results
Total calculated blood loss (2,100±1,632 ml) differed significantly from visible blood loss (564±319 ml). In addition, the blood loss of unstable fracture patient was 2,496±1,395 ml and multivariate analysis showed a significant relationship between blood loss and fracture pattern (p<0.01). However, other factors showed no statistically significant difference.
Conclusion
Total calculated blood loss was much greater than visible blood loss. Patients with unstable intertrochanteric fracture should be treated with care in order to reduce blood loss.
Key words: Femur, Intertrochanteric fractures, Intramedullary nailing, Surgical blood loss, Risk factors

Financial support: None.

Conflict of interest: None.

REFERENCES

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Table 1

Characteristics of Studied Patients

Values are presented as number (%). GA: General anesthesia, SA: Spinal anesthesia, Hb: Hemoglobin, ASA: American Society of Anesthesiologists, BMI: Body mass index.

Table 2

Predictor of Total Blood Loss in Patients Who Underwent Intramedullary Fixation for Intertrochanteric Fracture in Student T-test

Values are presented as mean±standard deviation. GA: General anesthesia, SA: Spinal anesthesia, Hb: Hemoglobin, ASA: American Society of Anesthesiologists, BMI: Body mass index.

Table 3

Predictor of Total Blood Loss in Patients Underwent Intramedullary Fixation for Intertrochanteric Fracture in Multivariate Analysis

SE: Standard error, CI: Confidence interval, GA: General anesthesia, SA: Spinal anesthesia, Hb: Hemoglobin, ASA: American Society of Anesthesiologists, BMI: Body mass index.

Figure & Data

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Perioperative Blood Loss in Intramedullary Hip Screw for Intertrochanteric Fracture: Analysis of Risk Factors

J Korean Fract Soc. 2015;28(1):53-58. Published online January 31, 2015

DOI: https://doi.org/10.12671/jkfs.2015.28.1.53

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Perioperative Blood Loss in Intramedullary Hip Screw for Intertrochanteric Fracture: Analysis of Risk Factors

Table 1

Characteristics of Studied Patients

Values are presented as number (%). GA: General anesthesia, SA: Spinal anesthesia, Hb: Hemoglobin, ASA: American Society of Anesthesiologists, BMI: Body mass index.

Table 2

Predictor of Total Blood Loss in Patients Who Underwent Intramedullary Fixation for Intertrochanteric Fracture in Student T-test

Values are presented as mean±standard deviation. GA: General anesthesia, SA: Spinal anesthesia, Hb: Hemoglobin, ASA: American Society of Anesthesiologists, BMI: Body mass index.

Table 3

Predictor of Total Blood Loss in Patients Underwent Intramedullary Fixation for Intertrochanteric Fracture in Multivariate Analysis

SE: Standard error, CI: Confidence interval, GA: General anesthesia, SA: Spinal anesthesia, Hb: Hemoglobin, ASA: American Society of Anesthesiologists, BMI: Body mass index.

Table 1 Characteristics of Studied Patients

Values are presented as number (%). GA: General anesthesia, SA: Spinal anesthesia, Hb: Hemoglobin, ASA: American Society of Anesthesiologists, BMI: Body mass index.

Table 2 Predictor of Total Blood Loss in Patients Who Underwent Intramedullary Fixation for Intertrochanteric Fracture in Student T-test

Values are presented as mean±standard deviation. GA: General anesthesia, SA: Spinal anesthesia, Hb: Hemoglobin, ASA: American Society of Anesthesiologists, BMI: Body mass index.

Table 3 Predictor of Total Blood Loss in Patients Underwent Intramedullary Fixation for Intertrochanteric Fracture in Multivariate Analysis

SE: Standard error, CI: Confidence interval, GA: General anesthesia, SA: Spinal anesthesia, Hb: Hemoglobin, ASA: American Society of Anesthesiologists, BMI: Body mass index.