Fractures of the femur and blood transfusions

Adam Wertheimer, Alexander Olaussen, Shanaka Perera, Susan Liew, Biswadev Mitra

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Blood loss estimation after trauma (i.e. physical injury) and early identification of potential sources of bleeding are important for planning of investigation and management of trauma. Long bone fractures have been reported to be associated with substantial volumes of blood loss requiring blood transfusion. The aim of this study was to assess rates and amounts of blood transfusion in the setting of isolated extra capsular femur fractures and to determine variables associated with the need for transfusion within the first 48 h of admission. Methods: A retrospective cohort study was conducted of patients in The Alfred Trauma Registry with isolated extra capsular femur fractures over a 7-year period. We compared patients with a femoral shaft fracture (FSF) to patients with either distal femur or proximal femur fractures (i.e. extremity fracture). We collected data potentially associated with blood transfusion within 48 h as well as operation details and patient outcomes. Results: There were 293 patients included, of which 121 had FSF and 172 extremity fracture. 105 (36%) patients received a blood transfusion during their admission. Admission haemoglobin (AOR 0.92; 95%CI 0.89–0.94, p < 0.01) was the only independently associated variable with blood transfusion within the first 48 h of hospital admission. Conclusion: Volume of blood transfused to patients with extra-capsular femoral fractures was low and usually in the post-operative period. FSF, compared to femoral extremity fractures, were not more likely to receive blood transfusion within the first 48 h of admission, and did not receive a higher volume of blood overall. In the setting of major trauma with haemorrhagic shock, alternate sources of bleeding should be sought.

Original languageEnglish
Pages (from-to)846-851
Number of pages6
JournalInjury
Volume49
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018

Keywords

  • Blood transfusion
  • Femoral fractures
  • Femur
  • Hemorrhage
  • Hemorrhagic
  • Shock

Cite this

Wertheimer, Adam ; Olaussen, Alexander ; Perera, Shanaka ; Liew, Susan ; Mitra, Biswadev. / Fractures of the femur and blood transfusions. In: Injury. 2018 ; Vol. 49, No. 4. pp. 846-851.
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abstract = "Background: Blood loss estimation after trauma (i.e. physical injury) and early identification of potential sources of bleeding are important for planning of investigation and management of trauma. Long bone fractures have been reported to be associated with substantial volumes of blood loss requiring blood transfusion. The aim of this study was to assess rates and amounts of blood transfusion in the setting of isolated extra capsular femur fractures and to determine variables associated with the need for transfusion within the first 48 h of admission. Methods: A retrospective cohort study was conducted of patients in The Alfred Trauma Registry with isolated extra capsular femur fractures over a 7-year period. We compared patients with a femoral shaft fracture (FSF) to patients with either distal femur or proximal femur fractures (i.e. extremity fracture). We collected data potentially associated with blood transfusion within 48 h as well as operation details and patient outcomes. Results: There were 293 patients included, of which 121 had FSF and 172 extremity fracture. 105 (36{\%}) patients received a blood transfusion during their admission. Admission haemoglobin (AOR 0.92; 95{\%}CI 0.89–0.94, p < 0.01) was the only independently associated variable with blood transfusion within the first 48 h of hospital admission. Conclusion: Volume of blood transfused to patients with extra-capsular femoral fractures was low and usually in the post-operative period. FSF, compared to femoral extremity fractures, were not more likely to receive blood transfusion within the first 48 h of admission, and did not receive a higher volume of blood overall. In the setting of major trauma with haemorrhagic shock, alternate sources of bleeding should be sought.",
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Fractures of the femur and blood transfusions. / Wertheimer, Adam; Olaussen, Alexander; Perera, Shanaka; Liew, Susan; Mitra, Biswadev.

In: Injury, Vol. 49, No. 4, 01.04.2018, p. 846-851.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Fractures of the femur and blood transfusions

AU - Wertheimer, Adam

AU - Olaussen, Alexander

AU - Perera, Shanaka

AU - Liew, Susan

AU - Mitra, Biswadev

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background: Blood loss estimation after trauma (i.e. physical injury) and early identification of potential sources of bleeding are important for planning of investigation and management of trauma. Long bone fractures have been reported to be associated with substantial volumes of blood loss requiring blood transfusion. The aim of this study was to assess rates and amounts of blood transfusion in the setting of isolated extra capsular femur fractures and to determine variables associated with the need for transfusion within the first 48 h of admission. Methods: A retrospective cohort study was conducted of patients in The Alfred Trauma Registry with isolated extra capsular femur fractures over a 7-year period. We compared patients with a femoral shaft fracture (FSF) to patients with either distal femur or proximal femur fractures (i.e. extremity fracture). We collected data potentially associated with blood transfusion within 48 h as well as operation details and patient outcomes. Results: There were 293 patients included, of which 121 had FSF and 172 extremity fracture. 105 (36%) patients received a blood transfusion during their admission. Admission haemoglobin (AOR 0.92; 95%CI 0.89–0.94, p < 0.01) was the only independently associated variable with blood transfusion within the first 48 h of hospital admission. Conclusion: Volume of blood transfused to patients with extra-capsular femoral fractures was low and usually in the post-operative period. FSF, compared to femoral extremity fractures, were not more likely to receive blood transfusion within the first 48 h of admission, and did not receive a higher volume of blood overall. In the setting of major trauma with haemorrhagic shock, alternate sources of bleeding should be sought.

AB - Background: Blood loss estimation after trauma (i.e. physical injury) and early identification of potential sources of bleeding are important for planning of investigation and management of trauma. Long bone fractures have been reported to be associated with substantial volumes of blood loss requiring blood transfusion. The aim of this study was to assess rates and amounts of blood transfusion in the setting of isolated extra capsular femur fractures and to determine variables associated with the need for transfusion within the first 48 h of admission. Methods: A retrospective cohort study was conducted of patients in The Alfred Trauma Registry with isolated extra capsular femur fractures over a 7-year period. We compared patients with a femoral shaft fracture (FSF) to patients with either distal femur or proximal femur fractures (i.e. extremity fracture). We collected data potentially associated with blood transfusion within 48 h as well as operation details and patient outcomes. Results: There were 293 patients included, of which 121 had FSF and 172 extremity fracture. 105 (36%) patients received a blood transfusion during their admission. Admission haemoglobin (AOR 0.92; 95%CI 0.89–0.94, p < 0.01) was the only independently associated variable with blood transfusion within the first 48 h of hospital admission. Conclusion: Volume of blood transfused to patients with extra-capsular femoral fractures was low and usually in the post-operative period. FSF, compared to femoral extremity fractures, were not more likely to receive blood transfusion within the first 48 h of admission, and did not receive a higher volume of blood overall. In the setting of major trauma with haemorrhagic shock, alternate sources of bleeding should be sought.

KW - Blood transfusion

KW - Femoral fractures

KW - Femur

KW - Hemorrhage

KW - Hemorrhagic

KW - Shock

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U2 - 10.1016/j.injury.2018.03.007

DO - 10.1016/j.injury.2018.03.007

M3 - Article

VL - 49

SP - 846

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JO - Injury

JF - Injury

SN - 0020-1383

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ER -