Transfusion requirements in hip fractures: analysis of predictive factors

  • Arif GulEmail author
  • S. Sambandam
  • V. Shanbhag
  • G. Morgan
Original Article



The primary objective of this study was to identify factors which determine blood transfusion requirements in patients with hip fractures. Predicting a target population at a higher risk of requiring blood transfusion would enable a selective cross-matching policy and also help to establish the appropriate prophylactic measures.


It was a retrospective study including the time period between February 2003 and February 2005. All patients admitted with fracture neck of femur were included in the study. The following variables were noted perioperative Hb levels, type of fracture and surgery, age and gender and blood transfusion in the perioperative period.


There were 238 female and 72 male patients. The mean age was 82.7 years; range 53–100. Out of a total of 310 patients, 49 patients required a postoperative blood transfusion. The mean preoperative Hb of patients who required transfusion was 11; S.D.1.49 while those who did not require a transfusion it was 12.5; S.D.1.42. There were 168 hemiarthroplasties and 142 DHS fixations. Patients undergoing a DHS had a mean preoperative Hb level of 12.1 and a mean postoperative Hb of 9.1. Transfusion was required in 33 (23%) patients. Patients having hemiarthroplasty had a mean preoperative Hb level of 12.4 and a mean postoperative Hb of 10. Transfusion was requried in 16 (9.5%) patients. The univariate analysis showed a significant relationship between postoperative transfusion and the preoperative Hb level (P = 0.0001) and the type of fracture (= 0.001). However no relationship was found between transfusion and the age (= 0.423) and the gender of the patient (= 0.611). Preoperative Hb and type of fracture were found to be statistically significant on multivariate analysis as well.


The results of our study indicate that the most important factor in the prediction for blood transfusion in fracture neck of femur is the preoperative level of haemoglobin although the type of fracture is also important. Restrictive cross-matching for the high risk cases would improve costs in healthcare delivery and prevent unnecessary use of blood resources


Transfusion Hip fractures Predictive factors 

Besoins transfusionnels dans les fractures de hanche



L’objectif fondamental de cette étude était d’identifier les facteurs qui déterminent les exigences de la transfusion de sang chez les patients ayant une fracture de la hanche. Prédire une population cible à plus haut risque d’exiger la transfusion du sang permettrait une politique de tri sélective et aussi aiderait à établir les mesures prophylactiques appropriées.


Il s’est agi d’une étude rétrospective entre février 2003 et février 2005. Tous les malades admis avec une fracture du col du fémur ont été inclus dans l’étude. Les variables suivantes ont été prises en compte: taux d’hémoglobine (Hb) peri-opératoire, type de fracture et de chirurgie, âge et sexe, transfusion de sang dans la période péri-opératoire.


Il y avait 238 femmes et 72 hommes. L’âge moyen était 82.7 ans; extrêmes 53–100. Sur un total de 310 malades, 49 malades ont nécessité une transfusion de sang postopératoire. Le taux moyen de Hb pré-opératoire des malades nécessitant une transfusion était 11 (écart type 1.49); alors que le taux de ceux qui n’ont pas eu besoin de transfusion était de 12.5 (écart type 1.42). Il y avait 168 hémiarthroplasties et 142 ostéosynthèses DHS. Les malades qui eurent une DHS avaient un taux moyen pré-opératoire de Hb de 12.1 et un taux moyen post-opératoire de Hb de 9.1 La transfusion a été nécessaire chez 33 malades (23%). Les malades qui furent opérés par hémiarthroplastie avaient un taux moyen pré-opératoire de Hb de 12.4 et un taux moyen post-opératoire de Hb de 10. La transfusion a été nécessaire chez 16 malades (9.5%). L’analyse à une variable a mis en évidence une corrélation significative entre la transfusion post-opératoire et le taux de Hb pré-opératoire (P = 0.0001) et le type de fracture (= 0.001). Par contre aucun rapport n’a été trouvé entre la transfusion et l’âge (= 0.423) et le sexe du malade (= 0. 611). Le taux pré-opératoire de Hb et le type de fracture ont également été trouvés corrélés en étude à plusieurs variables.


Les résultats de notre étude indiquent que le facteur prédictif le plus important pour une transfusion de sang dans la fracture du col du fémur est le taux d’hémoglobine pré-opératoire, bien que le type de fracture soit aussi important. Un tri croisé réstrictif tenant compte des cas à haut risque permettrait un traitement plus adapté et éviterait le gaspillage des ressources sanguines.

Mots clés

Transfusion sanguine Fractures de hanche Facteurs prédictifs 


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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Arif Gul
    • 1
    • 3
    Email author
  • S. Sambandam
    • 2
  • V. Shanbhag
    • 1
  • G. Morgan
    • 1
  1. 1.Princess of Wales HospitalBridgendUK
  2. 2.Fairfield General HospitalBuryUK
  3. 3.Bangor, GwyneddUK

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