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      The necessity of routine postoperative laboratory tests after total hip arthroplasty for hip fracture in a semi-urgent clinical setting

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          Abstract

          Background

          Recent studies suggest that routine postoperative laboratory tests are not necessary after primary elective total hip arthroplasty (THA). This study aims to evaluate the utility of routine postoperative laboratory tests in patients undergoing THA for hip fracture in a semi-urgent clinical setting.

          Materials and methods

          This retrospective study included 213 consecutive patients who underwent primary unilateral THA for hip fractures. Patient demographics, clinical information, and laboratory tests were obtained from the electronic medical record system. Multivariate logistic regression analysis was performed to identify risk factors associated with abnormal laboratory test-related interventions.

          Results

          A total of 207 patients (97.18%) had abnormal postoperative laboratory results, which were mainly due to anemia (190/213, 89.20%) and hypoalbuminemia (154/213, 72.30%). Overall, 54 patients (25.35%) underwent a clinical intervention, 18 patients received blood transfusion, and 42 patients received albumin supplementation. Factors associated with blood transfusion were long operative time and low preoperative hemoglobin levels. Factors associated with albumin supplementation were long operative time and low preoperative albumin levels. Of the 33 patients with abnormal postoperative creatinine levels, 7 patients underwent a clinical intervention. For electrolyte abnormalities, sodium supplementation was not given for hyponatremia, three patients received potassium supplementation, and one patient received calcium supplementation.

          Conclusions

          This study demonstrated a high incidence of abnormal postoperative laboratory tests and a significant clinical intervention rate in patients who underwent THA for hip fracture in a semi-urgent clinical setting, which indicates that routine laboratory tests after THA for hip fracture are still necessary for patients with certain risk factors.

          Level of Evidence

          Level III.

          Trial registration Clinical trial registry number ChiCTR1900020690.

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          Most cited references53

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          The stress response to trauma and surgery

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            Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery

            Although wait times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide, controversy exists about the duration of the wait that leads to complications.
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              Hip fractures in the elderly: A world-wide projection

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                Author and article information

                Contributors
                xiangdong_wu@outlook.com
                jiacheng_l@yeah.net
                1370477908@qq.com
                jw_wangjoint@163.com
                qiuguixing_pumch@126.com
                drhuangwei68@gmail.com
                Journal
                J Orthop Traumatol
                J Orthop Traumatol
                Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology
                Springer International Publishing (Cham )
                1590-9921
                1590-9999
                10 November 2020
                10 November 2020
                December 2020
                : 21
                : 19
                Affiliations
                [1 ]GRID grid.452206.7, Department of Orthopaedic Surgery, , The First Affiliated Hospital of Chongqing Medical University, ; No. 1, Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016 China
                [2 ]Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730 China
                Author information
                http://orcid.org/0000-0002-8894-0982
                Article
                559
                10.1186/s10195-020-00559-3
                7655881
                33170383
                733e238a-0ed1-4163-8564-9ee2b6db0dbf
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 22 July 2020
                : 29 October 2020
                Funding
                Funded by: Special Fund for Local Scientific and Technological Development under the Guidance of the Central Government
                Award ID: Z135050009017
                Award Recipient :
                Categories
                Original Article
                Custom metadata
                © The Author(s) 2020

                Orthopedics
                total hip arthroplasty,hip fracture,laboratory test,anemia,hypoalbuminemia
                Orthopedics
                total hip arthroplasty, hip fracture, laboratory test, anemia, hypoalbuminemia

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