‘Hip fracture surgery without blood transfusion as safe as transfusion surgeries’

Marian Chu  Published 2018.08.09  16:49  Updated 2018.08.09 16:49


New research is showing that hip fracture surgeries without blood transfusions have no difference in the mortality rate or complications as surgeries with blood transfusion.

Inje University Paik Hospital Professor Yoon Byung-ho

More and more patients, especially seniors, are getting hip fracture surgery. Allogenic blood transfusion (ABT) is commonly required for the procedure in about 40 to 65 percent of elderly patients getting a hip fracture surgery. ABT is used for several reasons, including patients having low hemoglobin (Hb), blood loss caused by the fracture, or blood loss during and after surgery.

However, some patients refuse blood transfusions for religious reasons and fear of infections occurring during the transfusion process even in life-threatening situations. Surgeries without transfusions have also been regarded as “worrisome” because of supposedly high mortality and morbidity rates among patients.

A research team at Inje University Paik Hospital led by Professor Yoon Byung-ho from the department of orthopedics undertook the task of comparing the mortality rates and Hb rates, as well as other factors in patients who had hip fracture surgery with or without ABT.

The results of the study were published in the U.S. Journal of Orthopedic Trauma.

The team divided 314 patients over 65 who had hip fracture surgery into two groups. One group had hip fracture surgery with ABT while the other had the surgery without ABT. Researchers used the propensity score matching method to adjust for different characteristics between the two.

The team found that hip fracture surgeries without ABT did not have higher mortality rates or complications as operations performed with ABT. Researchers also found no statistically meaningful difference in mortality rates upon examining the two groups at intervals of 90 days and one year, as well as the entire study duration. Mean hemoglobin levels remained nearly the same on the first postoperative day, and both groups recovered entirely within two weeks.

Surgery duration was also similar. Surgeries with ABT took 80 minutes to complete, while non-ABT operations took 77 minutes. Length of hospitalization was nearly equal between the two groups – the ABT group stayed an average of 24 days, and the non-ABT group stayed for 26. Hospitalization fees were also almost the same, with the non-transfusion group having an average medical bill of $8,522 while the transfusion group had $8,615.

Hip fracture surgery without ABT is an up-to-date medical technique that minimizes hemorrhages in the process of treating internal and external diseases as well as optimally promoting blood production.

Inje University Paik Hospital’s Bloodless Center has been introducing the concept of non-blood transfusion since 1990 and expanded its scope not only to the department of internal medicine but surgery and organ transplantation. The center offers optimal treatment services for patients who have reservations regarding blood transfusions because of religious beliefs or other concerns.

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