38-216
Infección postoperatoria en las fracturas de cadera: la transfusión y su efecto inmunomodulador
Post surgical infection by hip fractures: inmunomodulation effect of allogenic blood transfusion
J. CUENCA ESPIÉRREZ*, JA. GARCÍA ERCE**, AA. MARTÍNEZ MARTÍN*, V. MANUEL SOLANO***, A. HERRERA RODRÍGUEZ* * SERVICIO DE CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA. ** SERVICIO DE HEMATOLOGÍA Y HEMOTERAPIA. *** SERVICIO DE MEDICINA PREVENTIVA. HOSPITAL UNIVERSITARIO MIGUEL SERVET. ZARAGOZA.
Recepción:
16/09/2008
Aceptación:
16/09/2008
Publicación:
16/09/2008
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Resumen (ES)
We have reviewed 163 trochanteric hip fractures
treated during 2000 and 2001 with proximal femoral unreamed
nail PFN. The following variables were analysed: age, gender,
kind of hip fracture (AO classification); haemoglobin (Hb) and
haematocrit (Hct) at the admission day, the day before surgery
and two days later, transfusion needs, infection morbidity,
total hospital stay and post surgical mortality (before 28
days). The 33% patients were diagnosed of post surgical
infection, 44% of them were transfused. Women were transfused
more than men. There were no differences by gender in
haematological parameters at admission day, but women had
lower haematocrit values at post surgical day. A post surgical
infection was diagnosed in 51% of transfused patients, but
only in 20% of non-transfused (p<0.001). The mortality rate
was 43% if the post surgical Hb value was lower than 80 g/l. If
Hb was higher 80 g/l the mortality rate was 24% in transfused
patients but 5% in non-transfused ones (p<0.05). The hospital
stay was higher in patients diagnosed of post surgical infection
(15.1 vs 12.8 days) (p<0.05) and the higher in transfused
patients (14.3 vs 13 days) (p<0.05). Conclusions: In the patients
affected by trochanteric hip fracture the allogenic blood is
associated with a higher rate of post surgical infection, higher
mortality rate and longer hospital stays.
treated during 2000 and 2001 with proximal femoral unreamed
nail PFN. The following variables were analysed: age, gender,
kind of hip fracture (AO classification); haemoglobin (Hb) and
haematocrit (Hct) at the admission day, the day before surgery
and two days later, transfusion needs, infection morbidity,
total hospital stay and post surgical mortality (before 28
days). The 33% patients were diagnosed of post surgical
infection, 44% of them were transfused. Women were transfused
more than men. There were no differences by gender in
haematological parameters at admission day, but women had
lower haematocrit values at post surgical day. A post surgical
infection was diagnosed in 51% of transfused patients, but
only in 20% of non-transfused (p<0.001). The mortality rate
was 43% if the post surgical Hb value was lower than 80 g/l. If
Hb was higher 80 g/l the mortality rate was 24% in transfused
patients but 5% in non-transfused ones (p<0.05). The hospital
stay was higher in patients diagnosed of post surgical infection
(15.1 vs 12.8 days) (p<0.05) and the higher in transfused
patients (14.3 vs 13 days) (p<0.05). Conclusions: In the patients
affected by trochanteric hip fracture the allogenic blood is
associated with a higher rate of post surgical infection, higher
mortality rate and longer hospital stays.
Palabras clave (ES):
Inmunomodelador
Anemia
Hemorragia
Fractura
Cadera
Transfusión
Inmunodepresión
Resumen (EN)
We have reviewed 163 trochanteric hip fractures
treated during 2000 and 2001 with proximal femoral unreamed
nail PFN. The following variables were analysed: age, gender,
kind of hip fracture (AO classification); haemoglobin (Hb) and
haematocrit (Hct) at the admission day, the day before surgery
and two days later, transfusion needs, infection morbidity,
total hospital stay and post surgical mortality (before 28
days). The 33% patients were diagnosed of post surgical
infection, 44% of them were transfused. Women were transfused
more than men. There were no differences by gender in
haematological parameters at admission day, but women had
lower haematocrit values at post surgical day. A post surgical
infection was diagnosed in 51% of transfused patients, but
only in 20% of non-transfused (p<0.001). The mortality rate
was 43% if the post surgical Hb value was lower than 80 g/l. If
Hb was higher 80 g/l the mortality rate was 24% in transfused
patients but 5% in non-transfused ones (p<0.05). The hospital
stay was higher in patients diagnosed of post surgical infection
(15.1 vs 12.8 days) (p<0.05) and the higher in transfused
patients (14.3 vs 13 days) (p<0.05). Conclusions: In the patients
affected by trochanteric hip fracture the allogenic blood is
associated with a higher rate of post surgical infection, higher
mortality rate and longer hospital stays.
treated during 2000 and 2001 with proximal femoral unreamed
nail PFN. The following variables were analysed: age, gender,
kind of hip fracture (AO classification); haemoglobin (Hb) and
haematocrit (Hct) at the admission day, the day before surgery
and two days later, transfusion needs, infection morbidity,
total hospital stay and post surgical mortality (before 28
days). The 33% patients were diagnosed of post surgical
infection, 44% of them were transfused. Women were transfused
more than men. There were no differences by gender in
haematological parameters at admission day, but women had
lower haematocrit values at post surgical day. A post surgical
infection was diagnosed in 51% of transfused patients, but
only in 20% of non-transfused (p<0.001). The mortality rate
was 43% if the post surgical Hb value was lower than 80 g/l. If
Hb was higher 80 g/l the mortality rate was 24% in transfused
patients but 5% in non-transfused ones (p<0.05). The hospital
stay was higher in patients diagnosed of post surgical infection
(15.1 vs 12.8 days) (p<0.05) and the higher in transfused
patients (14.3 vs 13 days) (p<0.05). Conclusions: In the patients
affected by trochanteric hip fracture the allogenic blood is
associated with a higher rate of post surgical infection, higher
mortality rate and longer hospital stays.
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