Turkish Journal of Geriatrics 2020 , Vol 23, Issue 3
THE EFFECT OF BLOOD TRANSFUSION AND TRANEXAMIC ACID ON LENGTH OF HOSPITAL STAY AND MORTALITY AFTER HIP FRACTURE SURGERY IN ELDERLY PATIENTS
Mutlu AKDOĞAN1, Halis Atıl ATİLLA1
1Dışkapı Yıldırım Beyazit Research and Training Hospital, Orthopaedics and Traumatology, Ankara, Turkey DOI : 10.31086/tjgeri.2020.171 Introduction: The timely and appropriate administration of the transfusion of blood and/or blood components may considerably improve patient outcomes of geriatric hip fractures. However, the transfusion requirement is not free of complications. The purpose of this study was to evaluate the outcomes of geriatric hip fracture patients who required transfusion and antifibrinolytic treatment.

Material-Method: This study included geriatric patients with a hip fracture who were admitted to our institution between 2017 and 2018. Patient outcomes were evaluated in respect of mortality and length of hospital stay according to the need for blood transfusion.

Results: The data of 502 patients were analyzed. In-hospital mortality was recorded for 20 patients (4%). A median of 2 units of red blood cells were used in 218 patients (43.4%), median 2 units of platelet concentrates were used in 4 patients (0.8%), and a median of 2 units of fresh frozen plasma were used in 29 patients (5.8%). Length of hospital stay, and intensive care unit stay were significantly higher for patients who received blood products (p<0.05). The inpatient mortality rates were similar for patients who received and did not receive blood products (p>0.05) but were significantly low in patients who received tranexamic acid (1.2% vs. 5.3% respectively, p<0.05).

Conclusion: Blood transfusion in geriatric hip fractures is often associated with long-term hospital and intensive care stays and mortality. In addition, the results of this study revealed that inpatient mortality is significantly low in elderly patients with hip fractures who administered TXA perioperatively. Keywords : Blood transfusion; Geriatrics; Hip fractures; Tranexamic acid; Mortality; Length of stay