PMID- 33549313
OWN - NLM
STAT- MEDLINE
DCOM- 20211102
LR  - 20211102
IS  - 1879-0267 (Electronic)
IS  - 0020-1383 (Linking)
VI  - 52
IP  - 10
DP  - 2021 Oct
TI  - Can early surgery reduce the need to packed red blood cell transfusion in elderly 
      patients with intertrochanteric femur fractures?
PG  - 3047-3050
LID - S0020-1383(21)00074-7 [pii]
LID - 10.1016/j.injury.2021.01.036 [doi]
AB  - INTRODUCTION: This study was designed to compare and analyse the amount of packed 
      red blood cell transfusions (PRBCTs) in relation to surgical timing in elderly 
      patients undergoing cephalomedullary nailing due to intertrochanteric fractures. 
      MATERIALS AND METHODS: A total of 110 patients (24 men, 86 women) who had 
      received cephalomedullary nailing for intertrochanteric fractures were 
      retrospectively investigated. A restrictive transfusion strategy was followed 
      during the peri-operative period. Patient characteristics and fracture 
      classifications, methods of anaesthesia, time interval from admission to surgery 
      (TI) and operative duration (OD) were investigated. The amount of PRBCTs was 
      measured and categorised as pre-operative, post-operative and entire 
      peri-operative values. The patients were divided into early surgery (ES) and 
      delayed surgery (DS) groups based on surgical treatment within or after 48 h of 
      admission. In addition, multiple regression analysis including TI and other 
      factors likely to affect blood loss and PRBCT was conducted to objectively 
      evaluate the impact of TI on the amount of the entire peri-operative PRBCT. 
      RESULTS: The patients had a mean age of 82.6 years (range, 68-98), mean TI of 
      41.1 h (range, 5-110) and mean OD of 37 min (range, 15-90). Although the amount 
      of pre-operative PRBCT was significantly different between the ES and DS groups 
      (36.2 ml vs. 168.3 ml, p < 0.001), they displayed no remarkable difference 
      regarding post-operative and the entire peri-operative amount of PRBCTs (279.7 ml 
      vs. 189.8 ml, p = 0.064 and 315.9 ml vs. 358.0 ml, p = 0.992, respectively). The 
      results from multiple regression analysis demonstrated that TI did not 
      significantly affect the amount of the entire peri-operative PRBCT. CONCLUSIONS: 
      If an appropriate transfusion strategy is adopted, TI does not seem to affect the 
      amount of peri-operative PRBCT in elderly patients with intertrochanteric 
      fractures. Nevertheless, careful transfusion management with a view to 
      compensating for any drop in pre-operative haemoglobin is necessary when surgery 
      is delayed.
CI  - Copyright (c) 2021. Published by Elsevier Ltd.
FAU - Kim, Keong-Hwan
AU  - Kim KH
AD  - Department of Orthopaedic Surgery, Kangwon National University Hospital, 
      Baengnyeong-ro 156, Chuncheon-Si, Gangwon-Do 24289, Republic of Korea. Electronic 
      address: osmedi03@gmail.com.
FAU - Kim, Nam Yeop
AU  - Kim NY
AD  - Department of Orthopaedic Surgery, Kangwon National University Hospital, 
      Baengnyeong-ro 156, Chuncheon-Si, Gangwon-Do 24289, Republic of Korea.
LA  - eng
PT  - Journal Article
DEP - 20210129
PL  - Netherlands
TA  - Injury
JT  - Injury
JID - 0226040
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Erythrocyte Transfusion
MH  - Female
MH  - Femur
MH  - *Fracture Fixation, Intramedullary
MH  - *Hip Fractures/surgery
MH  - Humans
MH  - Male
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Haemoglobin
OT  - Intertrochanteric fracture
OT  - Packed red blood cell transfusion
OT  - Surgical timing
COIS- Declaration of Competing Interest The authors declare that they have no competing 
      interest.
EDAT- 2021/02/08 06:00
MHDA- 2021/11/03 06:00
CRDT- 2021/02/07 20:31
PHST- 2020/11/18 00:00 [received]
PHST- 2021/01/21 00:00 [revised]
PHST- 2021/01/23 00:00 [accepted]
PHST- 2021/02/08 06:00 [pubmed]
PHST- 2021/11/03 06:00 [medline]
PHST- 2021/02/07 20:31 [entrez]
AID - S0020-1383(21)00074-7 [pii]
AID - 10.1016/j.injury.2021.01.036 [doi]
PST - ppublish
SO  - Injury. 2021 Oct;52(10):3047-3050. doi: 10.1016/j.injury.2021.01.036. Epub 2021 
      Jan 29.