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[Background] To explore the influencing factors of perioperative hidden blood loss of intertrochanteric fractures. [Method] We undertook a retrospective analysis from January 2016 to October 2019. Clinical data of 118 patients with intertrochanteric fractures was included in. Hidden blood loss was calculated from the hematocrit changes before and after surgery, using the Gross equation, based on height, weight, and hematocrit (HCT) changes before and after surgery. Patients’ gender, age, presence of underlying diseases (hypertension and diabetes), fracture types, internal fixation methods, anesthesia methods, time from injury to surgery, whether to take antiplatelet drugs within 6 months before surgery, use of anticoagulant drugs after surgery, bone density were statistically analyzed. The factors with statistical significance were screened out. And then the hidden blood loss was used as the dependent variable and each influencing factor was the independent variable. Multivariate linear regression analysis was used to analyze the related risk factors that affect the hidden blood loss during the perioperative period of intertrochanteric fractures. [Result] The apparent blood loss during operation was (203.81 ±105. 51) ml, and the hidden blood loss was (517.55±191.47) ml. There were significant differences in the hidden blood loss of patients with different internal fixation methods, fracture types, anesthesia methods, antiplatelet or postoperative anticoagulant drugs, and different bone density(P＜0. 05). Multiple linear regression analysis showed that internal fixation, age, fracture type, anesthesia method, anticoagulant application, and bone density were related risk factors that affected hidden blood loss during surgical treatment of intertrochanteric fracture.
[Conclusion] Hidden blood loss is the main cause of perioperative blood loss in intertrochanteric fractures, and the risk factors for hidden blood loss include internal fixation, fracture type, anesthesia, use of anticoagulant drugs. Specially, we found bone density was a risk factor for hidden blood loss. It is not reliable to use the apparent blood loss as the basis for fluid replacement and transfusion. We must fully consider the existence of hidden blood loss and intervene as soon as possible to prevent complications.
Keywords
Intertrochanteric fracture, Hidden blood loss, Influencing factors, Bone density
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CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
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Editorial decision: Accept
On 22 Dec, 2020
Editor assigned
On 12 Dec, 2020
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On 12 Dec, 2020
Editor invited
On 12 Dec, 2020
No comments provided
Review #1 received
Received 30 Nov, 2020
Reviewer #1 agreed
On 12 Nov, 2020
Reviewers invited
Invitations sent on 11 Nov, 2020
Editor assigned
On 03 Nov, 2020
Submission checks complete
On 03 Nov, 2020
Editor invited
On 03 Nov, 2020
No comments provided
Editorial decision: Major revision
On 26 Oct, 2020
Review #3 received
Received 20 Oct, 2020
Reviewer #3 agreed
On 05 Oct, 2020
Review #1 received
Received 05 Oct, 2020
Review #2 received
Received 05 Oct, 2020
Reviewer #1 agreed
On 01 Oct, 2020
Reviewer #2 agreed
On 01 Oct, 2020
Reviewers invited
Invitations sent on 29 Sep, 2020
Editor assigned
On 01 Sep, 2020
Submission checks complete
On 31 Aug, 2020
Editor invited
On 31 Aug, 2020
Version 2
Posted 10 Jul, 2020
No comments provided
Editorial decision: Major revision
On 27 Aug, 2020
Review #2 received
Received 06 Aug, 2020
Reviewer #2 agreed
On 18 Jul, 2020
Review #1 received
Received 13 Jul, 2020
Reviewer #1 agreed
On 12 Jul, 2020
Editor assigned
On 09 Jul, 2020
Reviewers invited
Invitations sent on 09 Jul, 2020
Submission checks complete
On 08 Jul, 2020
Editor invited
On 08 Jul, 2020
No comments provided
Editor assigned
On 30 Apr, 2020
Editorial decision: Major revision
On 30 Apr, 2020
Submission checks complete
On 22 Apr, 2020
Editor invited
On 22 Apr, 2020
First submitted
On 16 Apr, 2020
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See the published version of this preprint at BMC Musculoskeletal Disorders.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Editorial decision: Accept
On 22 Dec, 2020
Editor assigned
On 12 Dec, 2020
Submission checks complete
On 12 Dec, 2020
Editor invited
On 12 Dec, 2020
No comments provided
Review #1 received
Received 30 Nov, 2020
Reviewer #1 agreed
On 12 Nov, 2020
Reviewers invited
Invitations sent on 11 Nov, 2020
Editor assigned
On 03 Nov, 2020
Submission checks complete
On 03 Nov, 2020
Editor invited
On 03 Nov, 2020
No comments provided
Editorial decision: Major revision
On 26 Oct, 2020
Review #3 received
Received 20 Oct, 2020
Reviewer #3 agreed
On 05 Oct, 2020
Review #1 received
Received 05 Oct, 2020
Review #2 received
Received 05 Oct, 2020
Reviewer #1 agreed
On 01 Oct, 2020
Reviewer #2 agreed
On 01 Oct, 2020
Reviewers invited
Invitations sent on 29 Sep, 2020
Editor assigned
On 01 Sep, 2020
Submission checks complete
On 31 Aug, 2020
Editor invited
On 31 Aug, 2020
Version 2
Posted 10 Jul, 2020
No comments provided
Editorial decision: Major revision
On 27 Aug, 2020
Review #2 received
Received 06 Aug, 2020
Reviewer #2 agreed
On 18 Jul, 2020
Review #1 received
Received 13 Jul, 2020
Reviewer #1 agreed
On 12 Jul, 2020
Editor assigned
On 09 Jul, 2020
Reviewers invited
Invitations sent on 09 Jul, 2020
Submission checks complete
On 08 Jul, 2020
Editor invited
On 08 Jul, 2020
No comments provided
Editor assigned
On 30 Apr, 2020
Editorial decision: Major revision
On 30 Apr, 2020
Submission checks complete
On 22 Apr, 2020
Editor invited
On 22 Apr, 2020
First submitted
On 16 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Musculoskeletal Disorders.
[Background] To explore the influencing factors of perioperative hidden blood loss of intertrochanteric fractures. [Method] We undertook a retrospective analysis from January 2016 to October 2019. Clinical data of 118 patients with intertrochanteric fractures was included in. Hidden blood loss was calculated from the hematocrit changes before and after surgery, using the Gross equation, based on height, weight, and hematocrit (HCT) changes before and after surgery. Patients’ gender, age, presence of underlying diseases (hypertension and diabetes), fracture types, internal fixation methods, anesthesia methods, time from injury to surgery, whether to take antiplatelet drugs within 6 months before surgery, use of anticoagulant drugs after surgery, bone density were statistically analyzed. The factors with statistical significance were screened out. And then the hidden blood loss was used as the dependent variable and each influencing factor was the independent variable. Multivariate linear regression analysis was used to analyze the related risk factors that affect the hidden blood loss during the perioperative period of intertrochanteric fractures. [Result] The apparent blood loss during operation was (203.81 ±105. 51) ml, and the hidden blood loss was (517.55±191.47) ml. There were significant differences in the hidden blood loss of patients with different internal fixation methods, fracture types, anesthesia methods, antiplatelet or postoperative anticoagulant drugs, and different bone density(P＜0. 05). Multiple linear regression analysis showed that internal fixation, age, fracture type, anesthesia method, anticoagulant application, and bone density were related risk factors that affected hidden blood loss during surgical treatment of intertrochanteric fracture.
[Conclusion] Hidden blood loss is the main cause of perioperative blood loss in intertrochanteric fractures, and the risk factors for hidden blood loss include internal fixation, fracture type, anesthesia, use of anticoagulant drugs. Specially, we found bone density was a risk factor for hidden blood loss. It is not reliable to use the apparent blood loss as the basis for fluid replacement and transfusion. We must fully consider the existence of hidden blood loss and intervene as soon as possible to prevent complications.
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