[Analysis of risk factors of perioperative blood transfusion in the treatment of femoral intertrochanteric fracture with proximal femoral nail antirotation].

Objective: To explore the influencing factors of perioperative blood transfusion in the treatment of elderly femoral intertrochanteric fractures with proximal femoral nail antirotation(PFNA).
Methods: The clinical data of 109 elderly patients with intertrochanteric fractures who received PFNA treatment from July 2018 to January 2020 were retrospectively analyzed. Both pelvic hip X-rays and CT plain scans were performed before surgery. All patients were diagnosed by X-ray and CT plain scan of pelvis and hip before operation. Through the statistical analysis of the basic data of patients before and during operation, the risk factors of perioperative blood transfusion were explored.
Results: Logistic regression analysis showed that age ( P =0.013), fracture type ( P <0.01), diabetes history ( P =0.031) and preoperative hemoglobin ( P <0.01) were independent risk factors for perioperative blood transfusion in the treatment of intertrochanteric fractures in elderly patients with 109 patients. Spearman correlation analysis showed that there was a positive correlation between blood transfusion and age of patients ( P = 0.017), fracture type ( P <0.01), diabetes history ( P =0.023), and negatively correlated with preoperative hemoglobin ( P <0.01). However, gender ( P =0.297), history of hypertension ( P =0.318) and operation time( P =0.325) had no significant relationship with perioperative blood transfusion.
Conclusion: Age, fracture type, diabetes history, and preoperative hemoglobin are independent risk factors for perioperative blood transfusion in the treatment of elderly intertrochanteric fractures with PFNA. The older the patient, the history of diabetes, the more unstable the fracture, and the lower preoperative hemoglobin, the more likely it is to require a blood transfusion, which may provide a reference for clinical perioperative blood transfusion decisions.