Risk Factors for Perioperative Hidden Blood Loss After Intertrochanteric Fracture Surgery in Chinese Patients: A Meta-Analysis

STUDY DESIGN: A meta-analysis INTRODUCTION: To perform a meta-analysis to explore the risk factors of perioperative hidden blood loss (HBL) in the treatment of intertrochanteric fracture for Chinese patients. SIGNIFICANCE: An extensive search of the literature was performed in the English databases of PubMed, Embase, and Cochrane Library and the Chinese databases of CNKI and WAN FANG (up to July 2021). We collected factors including demographic data and surgical factors. Data analysis was conducted with RevMan 5.3 and STATA 12.0. RESULTS: Finally, we collected 7 studies including 1377 patients in the final analysis. In our study, female patients (P <.00001), hypertension (P =.008), time from injury to operation (<2 days, P =.02), operation time (≥60 mins, P =.001), fracture type (A2.2 to A3.3, P <.00001), and without anticoagulation (P <.00001) were found to be associated with perioperative HBL in Chinese patients receiving the treatment of the intertrochanteric fracture. However, anesthesia, ASA classification, and body mass index were not associated with perioperative HBL. CONCLUSIONS: In our study, female patients, hypertension, time from injury to operation (<2 days), operation time (≥60 mins), fracture type (A2.2 to A3.3), and without anticoagulation were related to increased risks of perioperative HBL in Chinese patients receiving the treatment for the intertrochanteric fracture. We hope this article can guide for surgeons to reduce perioperative HBL as far as possible in the treatment of intertrochanteric fracture.