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Preoperative Risk Factors of Dillon et al for Blood Transfusion in a Patient with a Hip Fracture

Purpose: To determine if a patient with a hip fracture is likely to need a blood transfusion based on the study of Dillon et al.

Description

Dillon et al identified preoperative risk factors associated with blood transfusion in a patient with a hip fracture. These can help determine how to allocate blood products for these patients. The authors are from Adelaide & Meath Hospital and Trinity College Dublin in Ireland.


Mean transfusion trigger used in patients: 7.8 g/dL

 

Parameters:

(1) age of the patient

(2) admission hemoglobin

(3) location of the fracture

 

Parameter

Finding

Points

age of the patient in years

<= 75 years

0

 

> 75 years

1

admission hemoglobin

>= 12 g/dL

0

 

< 12 g/dL

1

location of the fracture

peritrochanteric

1

 

other

0

 

where:

• The probability of being transfused increases with age, from 5% at age 50 to 50% at age 90.

• The probability of being transfused increases with decreasing admission hemoglobin, reaching 85% for an admission hemoglobin of 8 g/dL.

 

total number of risk factors =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 3

• The higher the number of risk factors the greater the chances of being transfused.

• The authors recommended doing type and screen if 0 or 1 risk factor is present. For 2 or 3 risk factors they perform a type and crossmatch.

• Only a small percent of transfused units are administered intraoperatively. Usually these patients have >= 2 of the risk factors.


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Specialty

Objective

ICD-10