An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur
Objectives: The aim of this study was to analyze the changes in hemoglobin level and to determine a suitable timeline for post-operative hemoglobin monitoring in patients undergoing fixation of femoral neck fracture. Patients and methods: Patients who underwent either dynamic hip screw (DHS) fixatio...
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2016-10-01
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| Series: | Acta Orthopaedica et Traumatologica Turcica |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1017995X16301912 |
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| author | Navraj S. Nagra Dmitri van Popta Sigrid Whiteside Edward M. Holt |
| author_facet | Navraj S. Nagra Dmitri van Popta Sigrid Whiteside Edward M. Holt |
| author_sort | Navraj S. Nagra |
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| description | Objectives: The aim of this study was to analyze the changes in hemoglobin level and to determine a suitable timeline for post-operative hemoglobin monitoring in patients undergoing fixation of femoral neck fracture. Patients and methods: Patients who underwent either dynamic hip screw (DHS) fixation (n = 74, mean age: 80 years) or hip hemiarthroplasty (n = 104, mean age: 84 years) for femoral neck fracture were included into the study. The hemoglobin level of the patients was monitored perioperatively. Results: Analysis found a statistically and clinically significant mean drop in hemoglobin of 31.1 g/L over time from pre-operatively (D0) to day-5 post-operatively (p < 0.001), with significant reductions from D0 to day-1 and day-1 to day-2 (p < 0.001). At each post-operative time point, DHS patients had lower hemoglobin values over hemiarthroplasty patients (p = 0.046). Conclusion: The decrease in hemoglobin in the first 24-h post-operative period (D0 to day-1) is an underestimation of the ultimate lowest value in hemoglobin found at day-2. Relying on the day-1 hemoglobin could be detrimental to patient care. We propose a method of predicting patients likely to be transfused, and recommend a protocol for patients undergoing femoral neck fracture surgery to standardize postoperative hemoglobin monitoring. Level of evidence: Level IV Prognostic study. Keywords: Fracture, Hemoglobin, Neck of femur, Postoperative |
| format | Article |
| id | doaj-art-a15e0bd87d914867be8dbd736fb6da55 |
| institution | Kabale University |
| issn | 1017-995X |
| language | English |
| publishDate | 2016-10-01 |
| publisher | AVES |
| record_format | Article |
| series | Acta Orthopaedica et Traumatologica Turcica |
| spelling | doaj-art-a15e0bd87d914867be8dbd736fb6da552025-08-20T03:56:59ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2016-10-0150550751310.1016/j.aott.2015.11.001An analysis of postoperative hemoglobin levels in patients with a fractured neck of femurNavraj S. Nagra0Dmitri van Popta1Sigrid Whiteside2Edward M. Holt3University of Oxford, Oxford, UK; Corresponding author.University Hospital of South Manchester, NHS Foundation Trust, Wythenshawe M23 9LT, UKUniversity Hospital of South Manchester, NHS Foundation Trust, Wythenshawe M23 9LT, UKUniversity Hospital of South Manchester, NHS Foundation Trust, Wythenshawe M23 9LT, UKObjectives: The aim of this study was to analyze the changes in hemoglobin level and to determine a suitable timeline for post-operative hemoglobin monitoring in patients undergoing fixation of femoral neck fracture. Patients and methods: Patients who underwent either dynamic hip screw (DHS) fixation (n = 74, mean age: 80 years) or hip hemiarthroplasty (n = 104, mean age: 84 years) for femoral neck fracture were included into the study. The hemoglobin level of the patients was monitored perioperatively. Results: Analysis found a statistically and clinically significant mean drop in hemoglobin of 31.1 g/L over time from pre-operatively (D0) to day-5 post-operatively (p < 0.001), with significant reductions from D0 to day-1 and day-1 to day-2 (p < 0.001). At each post-operative time point, DHS patients had lower hemoglobin values over hemiarthroplasty patients (p = 0.046). Conclusion: The decrease in hemoglobin in the first 24-h post-operative period (D0 to day-1) is an underestimation of the ultimate lowest value in hemoglobin found at day-2. Relying on the day-1 hemoglobin could be detrimental to patient care. We propose a method of predicting patients likely to be transfused, and recommend a protocol for patients undergoing femoral neck fracture surgery to standardize postoperative hemoglobin monitoring. Level of evidence: Level IV Prognostic study. Keywords: Fracture, Hemoglobin, Neck of femur, Postoperativehttp://www.sciencedirect.com/science/article/pii/S1017995X16301912 |
| spellingShingle | Navraj S. Nagra Dmitri van Popta Sigrid Whiteside Edward M. Holt An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur Acta Orthopaedica et Traumatologica Turcica |
| title | An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur |
| title_full | An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur |
| title_fullStr | An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur |
| title_full_unstemmed | An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur |
| title_short | An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur |
| title_sort | analysis of postoperative hemoglobin levels in patients with a fractured neck of femur |
| url | http://www.sciencedirect.com/science/article/pii/S1017995X16301912 |
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