Objective To investigate the effect of postoperative hypocalcemia on the postoperative occult blood loss and blood transfusion ratio in elderly patients with hip fractures.Methods We collected elderly patients with hip fractures who were transferred to ICU after surgery at Beijing Jishuitan Hospital from January 2022 to January 2023.A total of 148 patients were included in the study,including 51 males and 97 females.The patient age ranged from 67 to 97 years,with an average age of (84.3±8.1) years.We corrected blood calcium concentration based on albumin.Blood calcium below 2.11 mmol/L was defined as hypocalcemia.50% of the patients transferred to ICU (148 cases) developed hypocalcemia (74 cases).Blood samples (hemoglobin and hematocrit) were collected immediately after the patient was transfered to the ICU after surgery,and blood transfusion volume during and two days after surgery was recorded.According to the calculation formula,the patient’s implicit blood loss within two days after surgery was calculated.Single factor and multiple factor linear regression were used to further analyze risk factors.Results A total of 148 patients were included.There was no significant difference in hemoglobin and hematocrit between the hypocalcemia group and the normal group.The blood transfusion ratio in the low calcium group (87.8%) was significantly higher than that in the normal group (51.4%),P<0.001.The occult blood loss in the low calcium group was 523.8 (159.6,993.8) mL,which was significantly higher than the 357.3(80.7,594.8) mL in the normal group(P=0.005).The blood transfusion volume in the normal group was 200 mL(0,400).The blood transfusion volume in the hypocalcemia group was 400 mL(400,400) mL,which was significantly higher than that in the normal group(P<0.001).The ICU hospitalization time in the low calcium group was significantly longer than that in the normal group(P=0.043).Analysis of risk factors related to postoperative occult blood loss showed that the independent risk factors associated with increased postoperative blood loss were fracture type(intertrochanteric fracture of the femur),blood transfusion volume,and hypocalcemia(P<0.05).Conclusion Postoperative patients with hypocalcemia have significantly increased occult blood loss,higher blood transfusion rates and volumes,and significantly prolonged ICU hospitalization.Fracture type(intertrochanteric fracture) and hypocalcemia are independent risk factors for increased postoperative blood loss.The results remind clinicians to pay attention to postoperative hypocalcemia,pay attention to intraoperative calcium supplementation,and optimize perioperative management for elderly patients with hip fracture.
白颖,于淼淼,金丽鲜,李智敏,李华杰,孔月月,周宁. 老年髋部骨折术后低钙血症与隐性失血量的相关性研究[J]. 实用骨科杂志, 2023, 29(7): 609-.
Bai Ying,Yu Miaomiao,Jin Lixian,Li Zhimin,Li Huajie,Kong Yueyue,Zhou Ning. Correlation between Postoperative Hypocalcemia and Postoperative Blood Loss in Elderly Patients With Hip Fracture. sygkzz, 2023, 29(7): 609-.
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