[Objective]To analyze the risk factors of postoperative blood transfusion of femoral intertrochanteric fracture in the elderly,and an established prediction equation was verified.[Methods]A retrospective study was done on 358 elderly patients who received surgi-cal treatment for femoral intertrochanteric fractures in our hospital from December 2016 to December 2021.The patients were divided into transfusion group and non-transfusion group according to whether postoperative blood transfusion occurred.The univariate comparisons and multi-factor binary logistic regression analysis were conducted to search the relative factors,and then a prediction model was estab-lished with its efficiency evaluated.[Results]Among the 358 patients,168(46.9％)received postoperative blood transfusion.In term of uni-variate comparison,the transfusion group were significantly older in age[(80.7±8.5)years vs(76.6±8.7)years,P＜0.001],lower BMI[(20.7± 3.3)kg/m2 vs(21.5±3.7)kg/m2,P=0.015],higher prevalence of hypertension[(105/63)vs(93/97),P=0.010],and more severe fracture types[A1/A2/A3,(40/93/35)vs(80/83/27),P＜0.001],longer operation time[(122.9±56.6)min vs(101.4±30.5)min,P＜0.001],more intraopera-tive blood loss[(258.3±218.9)ml vs(130.5±94.9)ml,P＜0.001],lower preoperative Hb[(93.1±14.8)g/L vs(111.6±14.2)g/L,P＜0.001],and lower preoperative Alb[(34.7±8.2)g/L vs(36.8±4.5)g/L,P=0.002]than the non-transfusion group,and all abovesaid were statistically sig-nificant between the two groups.As results of logistic regression analysis,the age(OR=1.053,P=0.007),operation time(OR=1.008,P=0.025),intraoperative blood loss(OR=1.007,P＜0.001)were the independent risk factors for postoperative transfusion,while the BMI(OR=0.900,P=0.025)and preoperative hemoglobin(OR=0.904,P＜0.001)were the independent protective factor.Based on the logistic regres-sion results,a prediction equation was established,which proved area under curve(AUC)of 0.894,95％CI 0.862～0.927,with cutoff of 0.578,the sensitivity of 74.4％,and the specificity of 88.4％by the ROC analysis.[Conclusion]The advanced age,longer operation time,more intraoperative bleeding,lower BMI and lower hemoglobin are independent risk factors for postoperative blood transfusion.The predic-tion model of postoperative blood transfusion might be helpful to judge the risk of transfusion and prevent it in advance.
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