Identify the trends of post-operative haemoglobin level change and risk factors for blood transfusions in surgically managed neck of femur fractures

Abstract

Introduction Neck of femur fracture (NOFF) is a major public health issue and there is a hidden blood loss during the surgery for the NOFF. Objectives To identify the trend of post-op anaemia and risk factors for blood transfusions in surgically managed Neck of femur fractures (NOFF). Materials and methods A prospective cohort analysis of 69 surgically managed NOFF patients was done for a period of 4 months. Age, sex, comorbidities, delay of admission, delay of surgery, type of fracture, level of the surgeon and diet of the patient were considered as risk factors for blood transfusions (BT). Pre-op and post-op day 1 and 3 Haemoglobin (Hb) and Haematocrit (Hct) values were assessed. Results Out of 69 patients who underwent surgery for NOFF, 28.9 % (n=20) received blood transfusions at some point of their management. Among non-transfused patients a significant decrease in Hb in post-op day 1 (mean drop =1.06 [95% CI = (0.807, 1.317) (P Conclusion Hb level continues to drop even on post-operative day 3. Postop Hb drop is partly due to haemodilution and extra capsular fractures has a higher risk of blood transfusion than intracapsular NOFF.