Transfusion Risk Factors in Low-Energy Pelvic Fractures: A Retrospective Cohort Study.

Introduction: The management of low-energy pelvic fractures poses a multifaceted challenge in orthopedic and geriatric care. With an increasing prevalence of patients taking new oral anticoagulant medications, it is unclear, which patients with pelvis fractures will have a significant life threatening bleed. The aim of this study was to assess the main risk factors leading to blood transfusion and longer hospital stay in patients with low-energy pelvic fractures. Materials and Methods: This single center retrospective observational study was performed with reference to STROBE guidelines. Demographic data, bleeding risk factors as well as blood transfusion rates were recorded. Initially, a univariate regression analysis was performed to analyze factors associated with blood transfusion. Significant variables were selected and a multidimensional predictive model was built based on variables that showed a significant relationship with the transfusion occurrence. Results: In total 167 patients were included in the study, there were 24 male and 143 female patients. The number of patients requiring blood transfusion was 20 (12%). Following univariate analysis, in final multivariate regression model, the only variable factors predicting the need for blood transfusion were low hemoglobin level on first hospital assessment (9.85 g/dl in transfused group vs 12 g/dl in non-transfused group, OR: 0.364, Conclusions: We suggest that all patients following low energy pelvic fractures have a haemoglobin level assessment in the emergency department. Patients with initial haemoglobin <10 g/dl should be considered for hospital admission and repeat blood tests within the first 24 hours.