Effect Of Time To Operation On Hidden Blood Loss And Outcome Of The Patients After Femoral Intertrochanteric Fractures Surgery

Objective:To investigate the effect of different operation timing on perioperative occult blood loss and prognosis of patients with femoral intertrochanteric fracture.Methods:Using the method of retrospective analysis,the clinical data of 174 patients with femoral intertrochanteric fracture treated in the Department of Orthopaedics,the first Hospital of Shanxi Medical University from September 2018 to December2020 were selected and collected.According to the timing of operation after injury,the patients were divided into three groups: group A(operation time ≤ 24 hours),group B(24 hours < operation time ≤ 48 hours)and group C(operation time > 24hours).The amount of hidden blood loss was calculated.Then a multiple linear regression equation was established,in which the dependent variable was hidden blood loss,and the independent variables were age,sex,affected side,fracture type,operation time,operation time and anesthesia mode,respectively,and the relationship between dependent variable and independent variable was compared.For the independent variables with statistical significance,the continuous numerical variables were analyzed by One-way ANOVA,and the rank variables were compared by Chi-square Test.The changes of hemoglobin level and hematocrit,perioperative hidden blood loss,mortality within one year after operation and hip score were compared among the three groups.Results:There was a linear regression relationship between operation time and sex and occult blood loss.The hidden blood loss in group B and C was701.81±69.33 ml and 702.62±69.77 ml respectively,which was significantly higher than that in group A(667.48±77.53ml).There was no significant difference in the amount of hidden blood loss between group B and group C(P > 0.05).The postoperative hemoglobin,hematocrit,hemoglobin and hematocrit in group A were 91.78±9.99g/L,26.39±4.24%,16.68±6.66 g / L and 8.64±3.58% respectively,there were significant differences between group B and group C(P < 0.05).The amount of occult blood loss in male patients was 704.20±76.92 ml,which was significantly higher than that in female patients(678.05±68.13ml)(P < 0.05).The one-year mortality rate of group A was 8.92%,which was lower than that of group C(12.77%).The difference was not statistically significant(P > 0.05).One year after operation,the hip joint scores of group A,group B and group C were83.02±9.46,81.80±10.06 and 77.77±10.69 respectively,the difference was statistically significant(P < 0.05).Conclusion:For patients with femoral intertrochanteric fracture,full preparation before operation and early operation can reduce the amount of recessive blood loss;during the perioperative period,the recessive blood loss of males is higher than that of females;for patients with femoral intertrochanteric fractures treated by surgery,early operation can improve the recovery of postoperative hip joint function and reduce postoperative mortality.