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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 8, 1053-1059.
doi: 10.1302/0301-620X.88B8.17534  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Hidden blood loss after surgery for hip fracture

N. B. Foss, MD, Research Fellow1; and H. Kehlet, MD, PhD, Professor2

1 Departments of Anaesthesiology and Orthopaedic Surgery, Spartavej 6, 2300 Kbh S, Copenhagen, Denmark.
2 Juliane Marie Centeret, Rigshospitalet, 2100 Kbh Ø, Copenhagen, Denmark.

Correspondence should be sent to Dr N. B. Foss; e-mail: nicolai.bang.foss{at}hh.hosp.dk

Our aim was to determine the total blood loss associated with surgery for fracture of the hip and to identify risk factors for increased blood loss. We prospectively studied 546 patients with hip fracture. The total blood loss was calculated on the basis of the haemoglobin difference, the number of transfusions and the estimated blood volume. The hidden blood loss, in excess of that observed during surgery, varied from 547 ml (screws/ pins) to 1473 ml (intramedullary hip nail and screw) and was significantly associated with medical complications and increased hospital stay. The type of surgery, treatment with aspirin, intra-operative hypotension and gastro-intestinal bleeding or ulceration were all independent predictors of blood loss.

We conclude that total blood loss after surgery for hip fracture is much greater than that observed intra-operatively. Frequent post-operative measurements of haemoglobin are necessary to avoid anaemia.




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Hidden blood loss after surgery for hip fracture
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J Bone Joint Surg Br Online, 20 Oct 2006 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General