scholarly journals Risk factors of perioperative blood transfusion in elderly patients with femoral intertrochanteric fracture

Medicine ◽  
2020 ◽  
Vol 99 (15) ◽  
pp. e19726
Author(s):  
Cheng-Qian Dai ◽  
Li-Hong Wang ◽  
Ye-Qin Zhu ◽  
Guo-Hong Xu ◽  
Jun-Biao Shan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Elderly Patients ◽  
Intertrochanteric Fracture ◽  
Femoral Intertrochanteric Fracture ◽  
Perioperative Blood Transfusion

scholarly journals Association between type of anesthesia and length of hospital stay in primary unilateral total knee arthroplasty patients: a single-center retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiaoqing Wang ◽  
He Li ◽  
Conghu Yuan ◽  
Hang Zhao
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Blood Transfusion ◽  
Elderly Patients ◽  
General Anesthesia ◽  
Regional Anesthesia ◽  
Length Of Hospital Stay ◽  
Regression Analyses ◽  
Total Knee ◽  
Perioperative Blood Transfusion

Abstract Objective This study explored the risk factors influencing the length of hospital stay (LOS) and establish whether the type of anesthesia is independently associated with the LOS in patients after primary unilateral total knee arthroplasty (TKA). Methods In this retrospective cohort study, 2309 patients undergoing unilateral TKA were recruited between January 2013 and June 2014 in a tertiary academic medical center in Singapore. Univariate and multivariate linear regression analyses were used to identify the independent risk factors associated with LOS. Besides, subgroup and interaction analyses were performed to evaluate the relationship between the type of anesthesia and LOS. Result In total, 2309 patients were identified. Out of these, 791 patients underwent general anesthesia, whereas 1518 patients underwent regional anesthesia. Multivariate regression analyses revealed that prolonged LOS was significantly associated with age ≥ 65 years (β = 0.48; 95% CI, 0.09–0.87; P = 0.015), diabetes mellitus (DM) (β = 0.8; 95% CI, 0.33–1.27; P = 0.001), congestive cardiac failure (CCF) (β = 4.1; 95% CI, 2.02–6.17; P < 0.001), perioperative blood transfusion (β = 5.71; 95% CI, 4.86–6.56; P < 0.001), creatinine > 2 mg/dL (β = 4.54; 95% CI, 2.46–6.62; P < 0.001), ASA status (III) (β = 1.72; 95% CI, 0.72–2.71; P = 0.001), general anesthesia (β = 0.78; 95% CI, 0.41–1.66; P < 0.001). The LOS further decreased among participants receiving regional anesthesia at advanced age (age ≥ 65 years) (β = − 1.12; 95% CI, − 1.66 to − 0.58; P < 0.001), patients with BMI ≤ 25 kg/m2 (β = − 1.92; 95% CI, − 2.73 to − 1.11; P < 0.001) or ≥ 30 kg/m2 (β = − 0.58; 95% CI, − 1.1 to − 0.06; P = 0.029). Conclusion Our findings demonstrated that age ≥ 65 years, DM, CCF, perioperative blood transfusion, creatinine > 2 mg/dL, ASA status (III), general anesthesia are associated with a prolonged LOS after primary TKA. Elderly patients (age ≥ 65 years) and patients with BMI ≤ 25 kg/m2 or ≥ 30 kg/m2 receiving regional anesthesia have a further reduced LOS. Therefore, when TKA is performed, priority for regional anesthesia is given to the elderly patients (age ≥ 65 years old) and those with BMI ≤ 25 kg/m2 or ≥ 30 kg/m2.

scholarly journals Admission deep venous thrombosis of lower extremity after intertrochanteric fracture in the elderly: a retrospective cohort study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jinzeng Zuo ◽  
Yongcheng Hu
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Lower Extremities ◽  
The Elderly ◽  
Intertrochanteric Fractures ◽  
Targeted Interventions ◽  
Laboratory Test Results

Abstract Objective The purpose of this study was to investigate the incidence, location, and related factors of deep venous thrombosis (DVT) of the bilateral lower extremities after intertrochanteric fractures in the elderly. Methods Retrospective analysis was performed on the elderly patients with intertrochanteric fracture who were admitted from January 2017 to December 2019. At admission, patients receive routine ultrasound Doppler scanning of bilateral lower extremities to detect DVT; those with DVT were assigned to the case group and those without DVT to the control group. Patient data on demographics, comorbidities, injury-related data, and laboratory test results at admission were extracted. Logistic regression analyses were conducted to identify the independent risk factors associated with DVT. Results Five hundred seventy-eight patients were included, among whom 116 (20.1%) had DVT. Among those with DV, 70.7% (82/116) had DVT of the distal type, 24 (29.6%) had DVT of the proximal type, and 10 (10.4%) had mixed DVT. In 76.7% (89/116) of patients, DVT occurred in the fractured extremity, 9.5% (11/116) in the bilateral and 13.8% (16/116) in the non-fractured extremity. Multivariate analyses identified obesity, delay to admission, increased D-dimer level (> 1.44 mg/L) and reduced albumin (< 31.7 g/L) as independent factors. Conclusions Admission incidence of DVT was high in elderly patients with intertrochanteric fractures, especially the proximal DVT. Identification of associated risk factors is useful for individualized assessment risk of DVT and early targeted interventions.

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.

96: Risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease

2020 ◽  
Vol 222 (3) ◽  
pp. S830-S831
Author(s):  
D. Timmons ◽  
M.M. Grady ◽  
M. Lederer ◽  
A. Wong ◽  
F. Andrade ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Benign Disease ◽  
Perioperative Blood Transfusion

Risk Factors Analysis of Postoperative Pleural Effusion after Liver Resection

2018 ◽  
Vol 36 (6) ◽  
pp. 514-521 ◽  
Author(s):  
Kuei-Yen Tsai ◽  
Hsin-An Chen ◽  
Wan-Yu Wang ◽  
Ming-Te Huang
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Blood Transfusion ◽  
Univariate Analysis ◽  
Pulmonary Complications ◽  
Older Age ◽  
Heavy Smoker ◽  
Chronic Obstructive ◽  
Heavy Smoking ◽  
Perioperative Blood Transfusion

Background: Pulmonary complications remain relatively high in morbidities that arise after liver surgery and are associated with increased length of hospital stay and higher cost. Identification of possible risk factors in this retrospective analysis may help reduce operative morbidity and achieve better outcomes. Methods: In all, 363 consecutive patients underwent elective hepatectomies between July 2008 and November 2013 and these were identified and analyzed retrospectively. Patient demographics and perioperative variables were collected. The main outcome was an analysis of risk factors associated with postoperative pleural effusion (PPE). Results: Of 363 patients receiving hepatectomies, 80 patients (22.0%) developed pulmonary complications. The predominant pulmonary complication in this series is pleural effusion (76 patients, 95%). Univariate analysis found that older age, higher body mass index (BMI), chronic obstructive lung disease, asthma, heart disease, hepatitis C infection, heavy smoking, American Society of Anesthesiology class III and IV, hepatectomy site, combined surgeries, perioperative blood transfusion, and cirrhosis of liver were associated with PPE. Only older age, higher BMI, asthma, heavy smoker, combined gastrointestinal surgeries, and perioperative blood transfusion were identified as independent risk factors in multivariate analysis. Conclusion: This study identifies 6 risk factors for PPE. Identification and management of some of these factors could possibly reduce morbidity and improve short-term surgical outcomes.

scholarly journals The Perioperative Nursing of Treating the Elderly Patients of Femoral Intertrochanteric Fracture with PFNA

2015 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Ying Zhang
Keyword(s):  
Elderly Patient ◽  
Elderly Patients ◽  
Intertrochanteric Fracture ◽  
Perioperative Period ◽  
The Elderly ◽  
Good Recovery ◽  
Surgical Risk ◽  
Perioperative Nursing ◽  
Femoral Intertrochanteric Fracture ◽  
Pull Through

<p><strong>Objective:</strong> Summarize the perioperative nursing of the elderly patient of femoral intertrochanteric fracture. <strong>Method: </strong>Retrospectively analyze the preoperative preparations as well as the postoperative nursing of treating the 75 elderly patients of femoral intertrochanteric fracture with PFNA. <strong>Results: </strong>Those 75 patients all pull through perioperative period and their functions are in good recovery. <strong>Conclusion:</strong> The elderly patient of femoral intertrochanteric fracture has much surgical risk together with many complications during perioperative period. Adopting effective comprehensive nursing can improve the treatment effect of the operation, and can also reduce the complications. </p>

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