Postoperative hemoglobin level in patients with femoral neck fracture

作者：Nagra Navraj S^*; van Popta Dmitri; Whiteside Sigrid; Holt Edward M

来源：Acta Orthopaedica et Traumatologica Turcica, 2016, 50(3): 315-322.

DOI：10.3944/AOTT.2015.15.0320

• Fracture
• hemoglobin
• neck of femur
• postoperative

Objective: The aim of this study was to analyze the changes of hemoglobin levels in patients undergoing fixation for femoral neck fracture.
Methods: Peroperative hemoglobin levels of patients who underwent either dynamic hip screw (DHS) fixation (n=74; mean age: 80 years) or hip hemiarthroplasty (n=104; mean age: 84 years) for femoral neck fracture was monitored.
Results: There was a statistically and clinically significant mean drop of 31.1 g/L between the preoperative (D0) and postoperative Day 5 Hb levels (p<0.001), with significant reductions from D0 to Day 1 and Day 1 to Day 2 (p<0.001). At each postoperative measurement, DHS patients had lower hemoglobin values over hemiarthroplasty patients (p=0.046).
Conclusion: The decrease in hemoglobin in the first 24-hour postoperative period (D0 to Day 1) is an underestimation of the ultimate lowest value in hemoglobin found at Day 2. Relying on the Day 1 hemoglobin level could be detrimental to patient care. We propose a method of predicting patients likely to be transfused and recommend a protocol for patients undergoing femoral neck fracture surgery to standardize postoperative hemoglobin monitoring.

• 出版日期2016-6