Abstract
Objective To identify the predictive factors for the need for transfusion during and after
surgery to treat hip fractures in the elderly and to evaluate a protocol to guide
the request for blood reserves for surgery.
Methods The medical records of 172 elderly patients undergoing surgical treatment for proximal
femoral fractures were collected. Data on sex, age, preoperative hemoglobin level,
diagnosis, and type of surgery were tested for correlation with blood transfusion.
In our sample, we determined the number of units of packed red blood cells reserved,
the transfusion rate, and the cross-test:transfusion ratio. We made the same calculations
in a hypothetical situation in which the request for blood reserves for our sample
followed the criteria of a defined protocol.
Results We found a correlation between the American Society of Anesthesiologists (ASA) classification
and the occurrence of transfusions, and an inverse correlation between the hemoglobin
level on admission and the number of bags transfused. A reserve of 328 units of packed
red blood cells was requested for 167 surgeries. Had the proposed protocol been applied,
72 units would have been requested for 61 surgeries.
Conclusion We found a correlation regarding the variables ASA classification and preoperative
hemoglobin level and the occurrence of transfusion. Applying a proposed protocol to
decide between requesting a reserve and only typing for elderly individuals undergoing
surgical treatment for hip fracture proved suitable to reduce the number of packed
red blood cell reserves.
Keywords
blood transfusion - blood typing - hip fractures
