BLOOD LOSS AND NEED FOR TRANSFUSION IN FRACTURES OF THE UPPER END OF THE FEMUR

Abstract

Aim: The aim was to study the blood loss and the need for transfusion in patients with fracture of the upper end of the femur.

Patients – Methods: In a prospective study we included 50 patients with intertrochanteric fractures (Group 1) and patients with fractures of the femoral neck (Group 2). Patients with other concomitant injuries or fractures were excluded. The blood loss and the need for transfusion were studied using as lower limit for transfusion Hb 10 gr./dl.

Results: The average age of the patients was 80.2 years (s.d. 8.3). Patients of the Group 2 (mean 73, s.d. 10) were younger than patients in Group 1 (average 82, s.d. 5.6).

Two thirds of the patients were women, with higher proportion of women in Group 1 (women: 81.3%, men:18.7%) than in Group 2 (women: 66.7%, men:33.3%).

In Group 1 the average blood loss (3.4 units) as well as the average need for transfusion (1.9 units) was higher than in Croup 2 (average blood loss 2.8 units, average need for transfusion 1.6 units). The average Hb admission in Group 1 was 11.4 and in Group 2 was 11.8.

In patients that were operated on within the first 24 hours after the injury, the average blood loss was lower than in patients who were operated on later.

Conclusions: In patients with intertrochanteric fractures the blood loss as well as the need for transfusion was higher than in patients with femoral neck fractures. Early surgical treatment led to less blood loss.