Hidden Blood Loss And Contributing Factors In Postoperative Period Of Femoral Intertrochanteric Fractures Patients Treated With Proximal Femoral Nail Anti-rotation

ObjectiveTo analyze blood loss and contributing factors in postoperative period of femoral intertrochanteric fracture patients treated with proximal femoral nail antirotation (PFNA) and to to identify risk factors for increased blood loss, thus serve for improving clinical curative effect conscientiously.MethodsWe prospectively studied 208 patients with femoral intertrochanteric fracture. The patients all come from the guangdong provincial hospital of traditional chinese medicine between January 2013 to February 2015and all accord with diagnostic, inclusion and exclusion criteria. The estimated blood loss was calculated by Gross and Nadler equations, on according to the gender, height, weight, blood transfusion volume, visible blood loss and changes of routine blood test pre- and post-operation. Correlation analysis was performed between hidden blood loss and gender, age, BMI, side, fracture type, hypertension, diabetes mellitus, time between the trauma and operation, the breviscapine injection, operation time.ResultsThe time between the trauma and operation was average (5.76±2.83) day, the average operation time was (69.76±21.67) min, the average minimum time in postoperative HCT was (3.21 ±1.04) day, the total blood loss was (773.16 ±289.65)mL, the hidden blood loss was (658.34±259.15) mL.The hidden blood loss was in 71.2%　of the total blood loss and was significantly higher in variables from the most to the least as follows:fracture type, gender, diabetes mellitus, operation time and hypertension (P<0.05).ConclusionThere is a considerable postoperative hidden blood loss of femoral intertrochanteric fractures patients treated with proximal femoral nail anti-rotation and and it is significantly associates with fracture type, gender, diabetes mellitus, operation time and hypertension. Hidden blood loss should not be neglected in clinic, especially multiple risk factors occurrence. Blood transfusion may be needed depending on blood loss in order to reduce the incidence of postoperative complications and improve the clinical effect.