Hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture: a retrospective study

Abstract Background Serum calcium is the critical coagulation factor in physiological coagulation, and hypocalcemia has been found to be associated with more blood loss in many diseases. The purpose of this study was to explore the effect of hypocalcemia on total blood loss (TBL) and blood transfusi...

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Main Authors: Yunqing Zhang, Kun Lu, Qi Liu, Chun Liu, Shilong Su, Chunhua Yang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-02872-2
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author Yunqing Zhang
Kun Lu
Qi Liu
Chun Liu
Shilong Su
Chunhua Yang
author_facet Yunqing Zhang
Kun Lu
Qi Liu
Chun Liu
Shilong Su
Chunhua Yang
author_sort Yunqing Zhang
collection DOAJ
description Abstract Background Serum calcium is the critical coagulation factor in physiological coagulation, and hypocalcemia has been found to be associated with more blood loss in many diseases. The purpose of this study was to explore the effect of hypocalcemia on total blood loss (TBL) and blood transfusion in elderly patients with hip fracture. Patients and methods Elderly patients with hip fracture undergoing surgery in our hospital were included in this study from January 2020 to May 2023. The demographic data, perioperative parameters, hemoglobin, hematocrit, and transfusion requirement were recorded and analyzed. Hypocalcemia was defined as an albumin-corrected calcium level of less than 2.15 mmol/L. TBL of each patient was calculated using the formulas of Nadler and Gross. Blood loss on the 1st and 5th postoperative days was calculated. Results 682 elderly patients with hip fracture were included in the study. On admission, the prevalence of hypocalcemia was 40.47%. Both the TBL on the first day (714.91 ± 396.05 ml vs. 640.31 ± 398.83 ml, P = 0.016) and the fifth day (1035.87 ± 528.77 ml vs. 859.92 ± 434.99 ml, P < 0.001) after operation in the hypocalcemia group were higher than those in the normocalcemia group. The preoperative, postoperative and perioperative blood transfusion rates of hypocalcemia patients were higher than those of the normocalcemia group. Conclusion Hypocalcemia was associated with increased TBL and blood transfusion in elderly patients with hip fracture during the perioperative period.
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spelling doaj-art-dd94aefbfdce4b8cb6bcf29ab365d6142025-08-20T01:53:04ZengBMCBMC Surgery1471-24822025-04-012511710.1186/s12893-025-02872-2Hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture: a retrospective studyYunqing Zhang0Kun Lu1Qi Liu2Chun Liu3Shilong Su4Chunhua Yang5Department of Orthopedics, The First Hospital of ChangshaDepartment of Orthopedics, The First Hospital of ChangshaDepartment of Orthopedics, The First Hospital of ChangshaDepartment of Orthopedics, The First Hospital of ChangshaDepartment of Orthopedics, Peking University Third HospitalDepartment of Orthopedics, The First Hospital of ChangshaAbstract Background Serum calcium is the critical coagulation factor in physiological coagulation, and hypocalcemia has been found to be associated with more blood loss in many diseases. The purpose of this study was to explore the effect of hypocalcemia on total blood loss (TBL) and blood transfusion in elderly patients with hip fracture. Patients and methods Elderly patients with hip fracture undergoing surgery in our hospital were included in this study from January 2020 to May 2023. The demographic data, perioperative parameters, hemoglobin, hematocrit, and transfusion requirement were recorded and analyzed. Hypocalcemia was defined as an albumin-corrected calcium level of less than 2.15 mmol/L. TBL of each patient was calculated using the formulas of Nadler and Gross. Blood loss on the 1st and 5th postoperative days was calculated. Results 682 elderly patients with hip fracture were included in the study. On admission, the prevalence of hypocalcemia was 40.47%. Both the TBL on the first day (714.91 ± 396.05 ml vs. 640.31 ± 398.83 ml, P = 0.016) and the fifth day (1035.87 ± 528.77 ml vs. 859.92 ± 434.99 ml, P < 0.001) after operation in the hypocalcemia group were higher than those in the normocalcemia group. The preoperative, postoperative and perioperative blood transfusion rates of hypocalcemia patients were higher than those of the normocalcemia group. Conclusion Hypocalcemia was associated with increased TBL and blood transfusion in elderly patients with hip fracture during the perioperative period.https://doi.org/10.1186/s12893-025-02872-2HypocalcemiaElderlyHip fractureBlood lossBlood transfusion
spellingShingle Yunqing Zhang
Kun Lu
Qi Liu
Chun Liu
Shilong Su
Chunhua Yang
Hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture: a retrospective study
BMC Surgery
Hypocalcemia
Elderly
Hip fracture
Blood loss
Blood transfusion
title Hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture: a retrospective study
title_full Hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture: a retrospective study
title_fullStr Hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture: a retrospective study
title_full_unstemmed Hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture: a retrospective study
title_short Hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture: a retrospective study
title_sort hypocalcemia was associated with increased perioperative blood loss and blood transfusion in elderly patients with hip fracture a retrospective study
topic Hypocalcemia
Elderly
Hip fracture
Blood loss
Blood transfusion
url https://doi.org/10.1186/s12893-025-02872-2
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