Abstract: Objective To evaluate the needs for perioperative allogeneic red blood cell transfusions (ABT) in elderly patients with hip fracture and the influence of different factors on ABT. Methods We conducted a study on elderly patients (≥65 years old) who were admitted to the geriatric trauma orthopedics ward of Beijing Jishuitan Hospital from January 2019 to December 2019 due to hip fracture. The perioperative data of the patients were collected, and univariate and multivariate stepwise Logistic regression analysis were performed to determine the risk factors for perioperative ABT. Results A total of 1 112 patients were included in this study, 50.6% of whom had a perioperative ABT. Univariate analysis showed that elderly patients with hip fracture in the perioperative ABT group were older, had more intraoperative blood loss (IBL), lower body mass index (BMI), lower hemoglobin and serum albumin at admission, longer prothrombin time (PT) and activated partial thromboplastin time (APTT), and shorter operative time. Female, intertrochanteric fractures, American Society of Anesthesiologists (ASA) classification ≥ Grade Ⅲ, general anesthesia, and patients without diabetes were more common. Multivariate stepwise Logistic regression analysis indicated that low hemoglobin at admission, intertrochanteric fracture, high IBL, advanced age, low BMI, ASA classification ≥Grade Ⅲ and general anesthesia were independent risk factors for perioperative ABT in elderly patients with hip fracture. Conclusion Perioperative ABT is very common in elderly patients with hip fracture. It is associated with low Hb at admission, intertrochanteric fracture, high IBL, advanced age, low BMI, ASA classification≥Grade Ⅲ and general anesthesia. These aspects can be considered to reduce perioperative ABT. Early and adequate blood preparation is required for the patients with immutable risk factors.

Key words: hip fracture, elderly patients, allogeneic red blood cell transfusions