Blood Loss And Transfusion Need During Operative Treatment Of Major Limb Fractures: Incidence And Risk

OBJECTIVE: To determine the incidence of excessive blood loss and transfusion needs during operative treatment of long bone fractures and identify risk factors for excessive blood loss. METHODS: A prospective study of fifty-nine patients was conducted, with excessive blood loss defined as blood loss in excess of 10% of patients' mean blood volume. RESULTS: Forty male and 19 females were studied, with mean age 43 years (range 14–85 years). Excessive blood loss occurred in 80% of the patients. The mean estimated blood loss (EBL) was 697mls. Twenty-five patients, 42%, were transfused and the mean number of unit transfused was 1.6 units per patient. Operative fixation, in the lower limb, of femur fracture, is a risk factor for excessive blood loss (p = 0.0007). The fixation device, fracture nonunion and preoperative haematocrit were not. CONCLUSION: Excessive blood loss may be common during operative treatment of long bone fractures. Adequate preoperative preparation should be made for transfusion especially in surgical environments where blood may not be readily available when urgently required. Nig Jnl Orthopaedics & Trauma Vol.2(2) 2003: 116-11