Relative Factors Analysis On Hidden Blood Loss After Intramedullary Fixation In Elderly Femoral Intertrochanteric Fracture Patients

Objective:To analyze the relative factors of hidden blood loss after closed reduction intramedullary nail internal fixation in elderly femoral intertrochanteric fracture patients,and to evaluate the protective effect of perioperative relative factors on adverse outcome caused by anemia after hidden blood loss,in order to guarantee clinical curative efficacy.Methods:The information from a total of 86 senior femoral intertrochanteric fracture patients who received closed reduction intramedullary nail internal fixation from September,2014 to March,2016 was included in this regression analysis.The absolute PHBL amount and its percentage of PBV in all patients were calculated by Cross formula,then PHBL and PBV were set as dependent variables in single-factor analysis and multiple-factor linear regression analysis,where the independent variables were gender,BMI,preoperative anti-coagulation status,operation duration and postoperative blood transfusion.Results:1、In PHBL group,single-factor analysis indicated statistical significance between preoperative anti-coagulation group and postoperative blood transfusion group(p<0.05),and multiple-factor linear regression analysis indicated linear regression relationship between preoperative anti-coagulaton group or postoperative blood transfusion group and absolute PHBL amount;2、In PHBL percentage group,statistical significances were observed among gender,BMI and preoperative coagulation(p<0.05),multiple-factor linear regression analysis indicated linear regression relationship between gender,BMI,preoperative anti-coagulation and PHBL percentage of PBV;3、The average absolute PHBL amounts and percentages in PBV were(647.52±63.23)ml and 14.2%±3.6% in male group;(652.72±70.31)ml and 18.6%±5.2% in female group.The average hidden blood loss amount and its percentage were(654.28±68.83)ml and 13.1%±4.7% in BMI≥24Kg/m2 group;(644.62±73.23)ml and 17.8%±6.3% in BMI<24Kg/m2 group;The average hidden blood loss amount and its percentage were(682.83±66.23)ml and 19.2%±3.3% in preoperative anti-coagulation group;(639.56±72.52)ml and 13.9%±4.1% in group without preoperative anti-coagulation;The average hidden blood loss amount and its percentage were(655.37±66.87)ml and 14.0%±4.3% in operation duration ≥80min group;(648.58±78.36)ml and 13.8%±7.1% in operation duration <80min group;The average hidden blood loss amount and its percentage were(627.76±53.64)ml and 14.7%±6.0% in postoperative blood transfusion group;(660.62±70.16)ml and 14.8%±3.6% in group without postoperative blood transfusion;Conclusion:Hidden blood loss is one of the critical factors affecting the functional rehabilitation in senior femoral intertrochanteric fracture patients who received closed reduction intramedullary nail internal fixation.The absolute PHBL amount was correlated with preoperative anti-coagulation and postoperative blood transfusion,and its percentage of PBV was correlated with gender,BMI and preoperative anti-coagulation.