Correlation between preoperative hidden blood loss and nutritional status in elderly patients with intertrochanteric fracture

doi:10.3969/j.issn.2095-4344.2016.37.003

Abstract

Abstract:

BACKGROUND: The emergence of a large number of hidden blood loss during perioperative period of intertrochanteric fracture in the elderly not only increases the risk of perioperative period and complications, but also affects the postoperative recovery of joint function. At present, there is no relevant report about nutritional status and the hidden blood loss before surgery in and outside China.
OBJECTIVE: To identify the effect of nutritional status on preoperative hidden blood loss in elderly patients with intertrochanteric fracture.
METHODS: 183 elderly patients with fresh and initial femoral intertrochanteric fracture were included. Laboratory serological examinations on admission and preoperation were completed. By mini nutritional assessment, patients were randomly divided into normal-nourishment group, malnourishment at risk group, and malnourishment group. The original blood volume and preoperative hidden blood loss were calculated depending on height, weight, hematocrit on admission and preoperation. According to the proportion of mean preoperative hidden blood loss on the original blood volume, patients were divided into low and high hidden blood loss groups. We compared preoperative hidden blood loss, and their proportion on the original blood volume and the preoperative incidence of high hidden blood loss, and analyzed the correlations between preoperative high hidden blood loss and preoperative nutritional status.
RESULTS AND CONCLUSION: (1) The nutritional status of elderly intertrochanteric fracture patients measured by mini nutritional assessment score was that the number of patients was 48 cases (26%) in normal-nourishment group, 64 cases (35%) in the malnourishment at risk group, and 71 cases (39%) in the malnourishment group. There were no obvious differences in the preoperative complications between any two groups (P > 0.05). (2) Thirty-eight cases affected high hidden blood loss. The mean preoperative hidden blood loss was 260.43 mL. The proportion of preoperative hidden blood loss to the original blood volume was 6%. (3) The preoperative hidden blood loss, their proportion on the original blood volume and the incidence of high hidden blood loss were significantly higher in the malnourishment at risk group and malnourishment group than in the normal-nourishment group. Paired comparison showed significant differences (P < 0.05). (4) Results confirmed that preoperative hidden blood loss, their proportion on the original blood volume and the incidence of high hidden blood loss gradually increased with deterioration of nutritional status. The nutritional status is an important factor influencing the occurrence of preoperative hidden blood loss, and can be used as an important index for judging the high hidden blood loss and prognosis in elderly patients with intertrochanteric fracture.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Femoral Fractures, Nutritional Status, Blood Loss, Surgical, Tissue Engineering

CLC Number:

R318

Liu Guo-yin, Zhang Yong, Bao Lei, Wang Jin, Xu Yuan-sheng, Wang Meng-ru, Jia Xiao-bao, Chen Jian-min. Correlation between preoperative hidden blood loss and nutritional status in elderly patients with intertrochanteric fracture[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(37): 5489-5459.

Figures/Tables 3

References

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