Investigation of perioperative hidden blood loss of unstable intertrochanteric fracture in the elderly treated with different intramedullary fixations

Injury ◽  
2017 ◽  
Vol 48 (8) ◽  
pp. 1848-1852 ◽  
Author(s):  
Xu Yang ◽  
Qiang Wu ◽  
Xin Wang
Keyword(s):  
Blood Loss ◽  
Intertrochanteric Fracture ◽  
The Elderly ◽  
Hidden Blood Loss ◽  
Unstable Intertrochanteric Fracture

scholarly journals Dynamic Analysis of Perioperative Hidden Blood Loss in Intertrochanteric Fractures

2019 ◽  
Vol 25 ◽  
pp. 107602961882327 ◽  
Author(s):  
Shuwei Tian ◽  
Hui Li ◽  
Meiyu Liu ◽  
Yanlong Zhang ◽  
Aqin Peng
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Intertrochanteric Fracture ◽  
Complete Blood Count ◽  
Dynamic Changes ◽  
Total Blood ◽  
Hidden Blood Loss ◽  
Postoperative Drainage ◽  
Males And Females ◽  
Perioperative Blood Transfusion

To analyze the dynamic variation in perioperative hidden blood loss in patients with intertrochanteric fracture. From January to December 2017, 79 patients with intertrochanteric fracture were treated with proximal femoral nail antirotation. Serial complete blood count assays were performed consecutively in the 3 days after admission, on the day of surgery, and 7 days postoperatively. Blood loss during surgery, postoperative drainage, and perioperative blood transfusion volumes were recorded. Dynamic changes in hemoglobin (Hb) prior to surgery were recorded and compared between males and females. Patients were divided into the no blood transfusion group, the 400-mL blood transfusion group, and the 800-mL blood transfusion group depending on the volume of perioperative blood transfusion. Total and hidden blood loss were separately calculated according to the Gross equation. Lowest mean Hb values occurred on day 2 after admission among men (104.8 g/L) and on day 3 after admission among women (98.6 g/L). The average Hb decrease was 11.4 g/L, 11.8 g/L, and 8.9 g/L in the no, 400-mL, and 800-mL blood transfusion groups, respectively. The lowest Hb value occurred on postoperative day 2. Hemoglobin increased on postoperative day 3 and stabilized by day 6. In the no blood transfusion group, the average total blood loss was 406.0 ± 255.6 mL, 628.3 ± 267.2 mL, and 759.7 ± 322.1 mL in the no blood transfusion, 400-mL blood transfusion, and 800-mL blood transfusion groups, respectively, and hidden blood loss was 326.0 ± 246.6 mL, 512.1 ± 247.3 mL, and 596.1 ± 306.9 mL, respectively. Perioperative hidden blood loss occurred prior to surgery for intertrochanteric fracture and ended on postoperative day 2.

scholarly journals Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Huixu Ma ◽  
Hairuo Wang ◽  
Xiaotao Long ◽  
Zexiang Xu ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Transfusion Rate ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hidden Blood Loss ◽  
Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture. Methods A prospective randomized controlled study was conducted with 125 patients (age ≥ 65 years, injury time ≤ 6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n = 63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n = 62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic days (PTDs) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis. Results Hgb on PTDs 2 and 3 was statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1–3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications. Conclusion Early IV TXA intervention could reduce post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

scholarly journals Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

2020 ◽  
Author(s):  
Hui Xu Ma ◽  
Hairuo Wang ◽  
Xiaotao Long ◽  
Zexiang Xu ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Transfusion Rate ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hidden Blood Loss ◽  
Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.Methods A prospective, randomized, controlled study was conducted with 125 patients (age ≥65 years, injury time ≤6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n=63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n=62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic day (PTD) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.Results Hgb on PTD 2 and 3 were statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group than in the NS group. Preoperative transfusion rate was significantly lower in the TXA group than in the NS group. There was no difference between the two groups with regard to the rates of complications.Conclusion Early IV TXA intervention could reduces post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

scholarly journals Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

2020 ◽  
Author(s):  
Hui Xu Ma ◽  
Hairuo Wang ◽  
Xiaotao Long ◽  
Zexiang Xu ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Transfusion Rate ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hidden Blood Loss ◽  
Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.Methods A prospective, randomized, controlled study was conducted with 125 patients (age ≥65 years, injury time ≤6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n=63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n=62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic day (PTD) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.Results Hgb on PTD 2 and 3 were statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications.Conclusion Early IV TXA intervention could reduces post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

scholarly journals Effects of aminocaproic acid on perioperative hidden blood loss in elderly patients with femoral intertrochanteric fracture treated with proximal femoral nail anti-rotation

2019 ◽  
Vol 47 (10) ◽  
pp. 5010-5018 ◽  
Author(s):  
Rui Zhang ◽  
Zhuqing Yang ◽  
Tao Lei ◽  
Zichuan Ping ◽  
Guangchao Bai
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Intertrochanteric Fracture ◽  
Aminocaproic Acid ◽  
Control Group ◽  
Hidden Blood Loss ◽  
Postoperative Drainage ◽  
Femoral Intertrochanteric Fracture ◽  
And Control ◽  
Experimental Group

Objective To determine the efficacy of aminocaproic acid on perioperative hidden blood loss (HBL) in elderly patients with femoral intertrochanteric fracture treated with proximal femoral nail anti-rotation (PFNA). Methods Seventy consecutively admitted elderly patients with femoral intertrochanteric fracture treated with PFNA between 1 May 2017 and 1 May 2018 were recruited. The patients were randomised into the experimental and control groups receiving 1 g aminocaproic acid in 200 mL saline and only 200 mL normal saline intravenously, respectively. The following factors were recorded: demographic characteristics, haemoglobin and haematocrit levels on preoperative day 1 and postoperative days 1 and 3, surgical blood loss, postoperative drainage, the rate and volume of transfusion, and complications. Results No significant differences were seen in surgical blood loss and postoperative drainage between the experimental and control groups, though total blood loss was greater in the control group. Visible blood loss and HBL were significantly lower in the experimental group than in the control group, and a lower rate and volume of transfusion were also recorded in the experimental group. Conclusion Aminocaproic acid significantly reduced perioperative HBL and volume and rate of transfusion in elderly patients with femoral intertrochanteric fracture receiving PFNA.

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