Background: To determine clinical and hematological
characteristics that could affect the use of blood and the
incidence of infections in patients with hip fractures (HF) treated
with a dynamic hip screw (DHS). Patients and Methods: A
retrospective study of all the HF patients during 5 years
(January 1995 – December 1999) treated with a dynamic hip
screw (DHS“). No patient was excluded. Age, gender, elapsed
time, anesthesia risk (ASA), type of HF (AO classification),
transfusion; hemoglobin (Hb) at admission and first postoperative
(POD#1) were examined. We analyzed the infection incidence
(CDC criteria), place and severity. The statistical univariate
analysis included Student’s t-test for numeric variables
and Pearson’s chi-squared test for string variables. There was
considered to be a statistically significant difference (SSD)
when p < 0.05. A multivariate stepwise logistic regression
model was used. Results: Three hundred and one patients with
HF were studied. 125 A1 and 176 A2, according to the AO classification.
Male/female ratio: 76/225; age 78.97 years; ASA: I, 53
(17.6%); II, 97 (32.2%); III, 138 (45.8%), and IV, 13 (4.3%). Hb
values on the day of admission: 12.87 g/dL and POD#1: 10.1
g/dL. A total of 186 (61.8%) patients were transfused with an
average 1.42 red cell concentrate (range: 0-6). 89 (29.6%) had
an infection: 79 (26.2%) urinary tract infection (UTI), 7 (2.3%)
pneumonia and 8 (2.7%) superficial wound. A 6% died in the
first month. At univariant study of transfusion act, the transfused
patients were older (p < 0.001), suffered more infections (p
= 0.019), more UTI (p = 0.003), had lower Hb on day 0 (p < 0.001)
and POD#1 (p < 0.001). When infections were analyzed, the
patients were older (p < 0.001), had higher ASA (p = 0.019),
lower Hb at day 0 (p < 0.026), longer stay (p < 0.001), were transfused
more (p = 0.019), and received more transfusions (p =
0.004). The logistic regression analysis identified only the type
of HF, the age and the Hb level (p < 0.05) as independent predictors
of transfusion. Comments: In patients with HF the Hb is
the most important predictor of blood transfusion, and it is
associated with a higher rate of postsurgical infection.

Background: To determine clinical and hematological
characteristics that could affect the use of blood and the
incidence of infections in patients with hip fractures (HF) treated
with a dynamic hip screw (DHS). Patients and Methods: A
retrospective study of all the HF patients during 5 years
(January 1995 – December 1999) treated with a dynamic hip
screw (DHS“). No patient was excluded. Age, gender, elapsed
time, anesthesia risk (ASA), type of HF (AO classification),
transfusion; hemoglobin (Hb) at admission and first postoperative
(POD#1) were examined. We analyzed the infection incidence
(CDC criteria), place and severity. The statistical univariate
analysis included Student’s t-test for numeric variables
and Pearson’s chi-squared test for string variables. There was
considered to be a statistically significant difference (SSD)
when p < 0.05. A multivariate stepwise logistic regression
model was used. Results: Three hundred and one patients with
HF were studied. 125 A1 and 176 A2, according to the AO classification.
Male/female ratio: 76/225; age 78.97 years; ASA: I, 53
(17.6%); II, 97 (32.2%); III, 138 (45.8%), and IV, 13 (4.3%). Hb
values on the day of admission: 12.87 g/dL and POD#1: 10.1
g/dL. A total of 186 (61.8%) patients were transfused with an
average 1.42 red cell concentrate (range: 0-6). 89 (29.6%) had
an infection: 79 (26.2%) urinary tract infection (UTI), 7 (2.3%)
pneumonia and 8 (2.7%) superficial wound. A 6% died in the
first month. At univariant study of transfusion act, the transfused
patients were older (p < 0.001), suffered more infections (p
= 0.019), more UTI (p = 0.003), had lower Hb on day 0 (p < 0.001)
and POD#1 (p < 0.001). When infections were analyzed, the
patients were older (p < 0.001), had higher ASA (p = 0.019),
lower Hb at day 0 (p < 0.026), longer stay (p < 0.001), were transfused
more (p = 0.019), and received more transfusions (p =
0.004). The logistic regression analysis identified only the type
of HF, the age and the Hb level (p < 0.05) as independent predictors
of transfusion. Comments: In patients with HF the Hb is
the most important predictor of blood transfusion, and it is
associated with a higher rate of postsurgical infection.