Analysis of the hemoglobin level drop in patients with hip fracture after admission

Abstract

The studies that evaluated blood loss during hip surgery found a relatively small loss that does not explain the large hemoglobin drop postoperatively. The aim of this study was to determine the fall in hemoglobin level after admission and rehydration in patients with hip fractures and to identify the patients that need blood transfusion. This retrospective study included data on 374 patients with hip fracture with surgery delayed by more than 24 hours and complete blood count repeated prior to surgery after fluid resuscitation for a minimum of 24 hours. The hemoglobin level (g/L) was analyzed after admission and after rehydration. The results were compared by Student's ttest. The mean hemoglobin drop was 6.1 g/L, 12.05 g/L and 16.52 g/L for capsular, pertrochanteric and subtrochanteric fractures, respectively. This hemoglobin drop was statistically significant in all fracture types. The significant drop of preoperative hemoglobin should be taken in consideration when planning transfusion for hip fracture patients. Collection of blood sample after rehydration preoperatively would enable prompt diagnosis and treatment of anemia in these patients, along with proper transfusion planning and cross-matching.