Preoperative Risk Factors of Dillon et al for Blood Transfusion in a Patient with a Hip Fracture

Mean transfusion trigger used in patients: 7.8 g/dL

Parameters:

(1) age of the patient

(2) admission hemoglobin

(3) location of the fracture

where:

• The probability of being transfused increases with age, from 5% at age 50 to 50% at age 90.

• The probability of being transfused increases with decreasing admission hemoglobin, reaching 85% for an admission hemoglobin of 8 g/dL.

total number of risk factors =

= SUM(points for all 3 parameters)

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 3

• The higher the number of risk factors the greater the chances of being transfused.

• The authors recommended doing type and screen if 0 or 1 risk factor is present. For 2 or 3 risk factors they perform a type and crossmatch.

• Only a small percent of transfused units are administered intraoperatively. Usually these patients have >= 2 of the risk factors.