Incidence, Clinical Characteristics and Blood Transfusion Factors of Elderly Patients undergoing Orthopedic Surgery in a Tropics University Hospital

Purpose: Identify clinical factors associated with blood transfusion with older patients undergoing orthopedic surgery. Patients and methods: This is a retrospective study of patients undergoing orthopedic surgery over a period of 24 months. Results: In total, 64 (21%) of patients aged 60 and older were included in the study. Males (42.2%) were the minority. Comorbidities were dominated by arterial hypertension (39.1%), diabetes mellitus (7.8%) and previous cerebrovascular events (strokes) (6.3%). Thirty-seven (57.8%) patients were ASA class 2-3. Loco-regional anesthesia (75%) was the most used anesthetic technique. This was combined with sedation in 5 cases (10.4%). Arterial hypotension (29.7%) and intra-operative bleeding (4.7%) were the main intra-operative incidents. The incidence of blood transfusion was 37.5%. Multiple logistic regression identified age ≥ 60 years (OR=5.33, 95% CI: 2.11 to 13.42, P=0.0004), duration of surgery (OR=1.02, 95% CI: 1.01 to 1.03, p<0.0001) and the presence of intra-operative events (OR=5.07, 95% CI: 2.34 to 11.00, p<0.0001) as risk factors associated with blood transfusion. Conclusion: This study shows a reconciliation of the clinical characteristics of elderly patients in the tropics from patients in developed countries. Clinical factors of transfusion are not specific of anesthetic and surgical practice in the tropics.