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Research article
Youhua Wang
Affiliated Hospital of Nantong University
Corresponding Author
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Background To explore the influencing factors of perioperative hidden blood loss in intertrochanteric fractures. Method We undertook a retrospective analysis from January 2016 to October 2019. Clinical data of 118 patients with intertrochanteric fractures were included. Hidden blood loss was calculated from the haematocrit changes before and after surgery using the Gross equation based on height, weight, and haematocrit (HCT) changes before and after surgery. Patients’ gender, age, presence of underlying diseases, fracture types, anaesthesia methods, time from injury to surgery, administration of antiplatelet drugs within 6 months before surgery, use of anticoagulant drugs after surgery, and bone density were statistically analysed. Factors having an effect on hidden blood loss were screened out. Then, hidden blood loss was used as the dependent variable, and each influencing factor was used in turn as the independent variable. Multivariate linear regression analysis was employed to analyse the related risk factors that affect hidden blood loss during the perioperative period of patients with intertrochanteric fractures.
Result The apparent blood loss during the 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 fracture types (stable vs unstable), anaesthesia methods (general anaesthesia vs intraspinal anaesthesia), antiplatelet or postoperative anticoagulant drugs, and bone densities (P<0.05). 05). Multiple linear regression analysis showed that internal fixation, age, fracture type, anaesthesia method, anticoagulant application, and bone density were related risk factors that affected hidden blood loss during the surgical treatment of intertrochanteric fractures. 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 (e.g., unstable), anaesthesia (e.g., intraspinal), and use of anticoagulant drugs. Specifically, we found that low bone density was a risk factor for hidden blood loss. It is not reliable to use 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
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On 12 Dec, 2020
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Received 30 Nov, 2020
Reviewer #1 agreed
On 12 Nov, 2020
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On 03 Nov, 2020
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On 03 Nov, 2020
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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
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
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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
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On 22 Apr, 2020
Editor invited
On 22 Apr, 2020
First submitted
On 16 Apr, 2020
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A new preprint design is coming!
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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
Youhua Wang
Affiliated Hospital of Nantong University
Corresponding Author
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.
Version 5
Posted 31 Dec, 2020
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
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 in intertrochanteric fractures. Method We undertook a retrospective analysis from January 2016 to October 2019. Clinical data of 118 patients with intertrochanteric fractures were included. Hidden blood loss was calculated from the haematocrit changes before and after surgery using the Gross equation based on height, weight, and haematocrit (HCT) changes before and after surgery. Patients’ gender, age, presence of underlying diseases, fracture types, anaesthesia methods, time from injury to surgery, administration of antiplatelet drugs within 6 months before surgery, use of anticoagulant drugs after surgery, and bone density were statistically analysed. Factors having an effect on hidden blood loss were screened out. Then, hidden blood loss was used as the dependent variable, and each influencing factor was used in turn as the independent variable. Multivariate linear regression analysis was employed to analyse the related risk factors that affect hidden blood loss during the perioperative period of patients with intertrochanteric fractures.
Result The apparent blood loss during the 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 fracture types (stable vs unstable), anaesthesia methods (general anaesthesia vs intraspinal anaesthesia), antiplatelet or postoperative anticoagulant drugs, and bone densities (P<0.05). 05). Multiple linear regression analysis showed that internal fixation, age, fracture type, anaesthesia method, anticoagulant application, and bone density were related risk factors that affected hidden blood loss during the surgical treatment of intertrochanteric fractures. 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 (e.g., unstable), anaesthesia (e.g., intraspinal), and use of anticoagulant drugs. Specifically, we found that low bone density was a risk factor for hidden blood loss. It is not reliable to use 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.
This is a list of supplementary files associated with this preprint. Click to download.
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