Optimal Hematocrit Level Associated with Blood Reservation for Surgery for Hip Fracture
DOI:
https://doi.org/10.56929/jseaortho-2026-0296Keywords:
Hematocrit, Hip fracture, Blood loss, Hip surgery, Blood transfusionAbstract
Purpose: To study the optimal hematocrit level associated with blood reservation for high hip fracture surgery.
Methods: We retrospectively studied the medical records of 56 patients with hip fractures who underwent surgery at our hospital between January and December 2022. Data were collected including hematocrit levels before and after surgery at 6, 48, and 72 h. Risk factors and hematocrit levels for blood transfusion were assessed using univariate, bivariate, and multivariate analyses and receiver operating characteristic (ROC) curves to determine the associated factors and optimal hematocrit level in patients with hip fractures.
Results: Fifty-six inpatient medical records showed a statistically significant difference in age, sex, and use of antiplatelet and/or anticoagulant drugs between the blood transfusion and non- transfusion groups. The group that received antiplatelet and/or anticoagulant drugs lost significantly more blood, 191.67 ± 172.67 ml, compared with 122.86 ± 75.49 ml in those who did not receive them. In the fractures at the intertrochanter of femur, the least intraoperative blood loss was statistically significant, at 110.00 ± 60.74 ml. Comparison with fractures at the neck and subtrochanteric of femur, the blood loss was 210.74 ± 126.06 ml and 1 liter, respectively. When divided into subgroups according to femoral neck fractures, the Garden 1 group had the least intraoperative blood loss, with statistical significance at 88.00 ± 52.63 ml. There was a linear relationship between estimated blood loss and body mass index (kg/m2), time to operation (days), and operative time (minutes), with R = 0.724 and R2 = 0.524. When analyzing the ROC, the optimal hematocrit level for blood reservation for hip fracture surgery was ≤34%. The sensitivity, specificity, and accuracy were 85.7 %, 60%, and 84.2 %, respectively.
Conclusions: The optimal hematocrit level in blood reservation planning is ≤34%, with accuracy of 84.2%.
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