Panteli et al reported predictors for blood transfusion following intramedullary nailing for subtrochanteric fractures. These can help to identify a patient who may require more aggressive management. The authors are from University of Leeds and Chapel Allerton Hospital in Leeds.
Patient selection: intramedullary nailing of a subtrochanteric fracture
Incidence of preoperative transfusion: 6%
Incidence of postoperative transfusion: 63%
Predictors of transfusion in the first 48 hour after surgery:
(1) preoperative hemoglobin < 100 g/L (OR 6.6)
(2) nail to canal ratio < 70% (OR 3.9)
(3) need for open reduction (OR 2.7)
(4) fracture involving the lesser trochanter (OR 2.1)
(5) preoperative moderate or severe renal impairment (OR 4.6)
(6) hypoalbuminemia on admission (OR 2.1)
The risk for transfusion increases with the number of risk factors present.
