RESUMO
This is a cohort study involving 98 patients who presented to a regional orthopaedic unit with a hip fracture. Blood loss was assessed by pre and post operative haemoglobin concentrations, and transfusion requirements were used as outcome measures. The influence of pre-operative aspirin use and fracture type was analysed with respect to these outcome measures. Forty two percent of patients were regular aspirin users, and were comparable to the non aspirin group, apart from having a significantly greater prevalence of atherosclerotic vascular disease. There was no significant difference between the aspirin and non aspirin groups in terms of preoperative haemoglobin concentrations, perioperative changes in haemoglobin levels and transfusion requirements. Fifty one percent of patients had extracapsular hip fractures, and these patients were comparable in terms of demographic characteristics, including aspirin use, to the group with intracapsular hip fractures. The extracapsular hip fracture group were found to have significantly increased peri-operative blood loss as measured by changes in the haemoglobin level, and in transfusion requirements when analysed against the intracapsular hip fracture group. We found that it is the fracture site, rather than aspirin use pre-operatively, that is predictive of blood loss and transfusion requirements in patients presenting with hip fractures.
Assuntos
Aspirina/efeitos adversos , Perda Sanguínea Cirúrgica , Transfusão de Sangue/estatística & dados numéricos , Fixação Interna de Fraturas/métodos , Fraturas do Quadril/cirurgia , Idoso , Idoso de 80 Anos ou mais , Aspirina/uso terapêutico , Tempo de Sangramento , Transfusão de Sangue/métodos , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Fixação Interna de Fraturas/efeitos adversos , Hemoglobinas/análise , Fraturas do Quadril/diagnóstico por imagem , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Radiografia , Valores de Referência , Medição de Risco , Resultado do TratamentoRESUMO
The determination of stroke volume (SV) is a potentially important application of real-time 3-dimensional echocardiography (RT3DE). SV measurements by thermodilution were compared with values obtained using transthoracic RT3DE in a sequential cohort of patients who underwent assessment for potential cardiac transplantation. There was a strong correlation between echocardiographically derived SV and catheterization data (r = 0.95, n = 14). On average, RT3DE appeared to underestimate SV by 7.5 ml (SD = 5.8) or 17% (SD = 12%). A role for RT3DE in the measurement of SV in severe heart failure is suggested.