Effect of early surgery on blood loss in proximal femur fracture patients: a retrospective study

The benefit of early surgery for proximal femoral fractures is widely recognized, but its impact on blood loss remains unclear. Comparisons of blood loss related to early surgery are complicated by the influence of anticoagulants. This retrospective study aimed to I have confirmedinvestigate the effect of early surgery within 48 h on perioperative blood loss in proximal femur fractures, adjusting for factors affecting blood loss using propensity score matching. Early surgery, with or without anticoagulants, reduces blood loss and transfusion requirements compared to delayed surgery. We retrospectively collected data from a cohort of patients aged ≥65 years with isolated proximal femoral fractures who underwent surgery at our hospital from January 2010 to December 2019. Blood loss was assessed from admission to the day after surgery, and blood transfusions were recorded within one week. Patients were divided into two groups: the early surgery group (surgery within 48 h, Group E) and the delayed surgery group (surgery after 48 h, Group W). Propensity score matching was used to adjust for potential confounders, and statistical analyses were performed to compare blood loss and transfusion rates between groups. A total of 829 patients (mean age: 83.7 ± 7.4 years; 653 females, 176 males) were included, with 441 in Group E and 388 in Group W. After matching, 261 patients were analyzed. Blood loss was significantly higher in Group E (553 mL) than in Group W (452 mL, p < 0.005). However, no significant difference was observed in transfusion rates between the groups (Group E: 61.6 %, Group W: 67.8 %; p = 0.186). Early surgery for proximal femur fractures reduces postoperative complications and mortality but should be performed with caution due to increased blood loss.