An Investigation Into the Risk Factors for Transfusion Need After Neck of Femur Fracture Surgery

Area of Science:

• Orthopedic surgery
• Geriatric medicine
• Transfusion medicine

Background:

• Neck of femur fractures are common in the elderly, often requiring blood transfusions.
• Current practice of cross-matching two units of red blood cells preoperatively is costly and carries risks for low-risk patients.
• Identifying individual transfusion risk factors can optimize preoperative protocols.

Purpose of the Study:

• To identify factors predicting the need for blood transfusion in patients undergoing neck of femur fracture surgery.
• To enable risk-stratified preoperative cross-matching practices.

Main Methods:

• Retrospective analysis of 319 patients undergoing neck of femur fracture surgery.
• Evaluation of risk factors: preoperative hemoglobin, age, gender, surgery type, fracture type, BMI, anticoagulants, and comorbidities.
• Binary logistic regression and odds ratios were used to assess predictors of transfusion need.

Main Results:

• 31% of patients received a blood transfusion.
• Preoperative hemoglobin and age were significant predictors of transfusion need.
• Older age, lower BMI, and lower preoperative hemoglobin were associated with higher transfusion rates. Certain comorbidities and fracture types also influenced transfusion likelihood.

Conclusions:

• Increased age and low preoperative hemoglobin are key risk factors for transfusion after neck of femur surgery.
• A risk prediction model could improve outcomes, reduce costs, and optimize resource use.
• Personalized preoperative cross-matching based on individual risk is recommended.