Abstract: Objective To investigate the characteristics of blood use and influencing factors of allogeneic blood transfusion in elderly orthopedic patients, thus providing information beneficial to the clinical management of blood use for such patients. Methods A total of 648 orthopedic patients age≥60 years were included, with 598 undergoing surgery and 50 conservative treatment. The blood use characteristics of surgical and conservative treatment groups were compared and analyzed. According to the disease classification and characteristics of blood use in surgery, 598 elderly patients undergoing orthopedic surgery were divided into eight groups. According to whether the patients received allogeneic transfusion or not, 598 patients were assigned into the transfusion group and the non-transfusion group. Preoperative baseline data, perioperative hemorheology indexes, autologous blood dosage, length of stay and in-hospital mortality were compared between the two groups, and their P values were calculated. Two groups were selected to compare P<0.1 variables, surgical classification and autotransfusion volume, etc, establish multiple multivariate logistic regression equation, and finally analyze the main factors affecting allogeneic blood transfusion in elderly orthopedic surgery patients. Results The variables influencing perioperative allogeneic blood transfusion in elderly orthopaedic surgery were Hb (OR: 0.948, P<0.001), cerebral infarction medical history (OR: 1.844, P=0.034), intraoperative blood loss (OR:1.005, P<0.001), intraoperative autotransfusion volume (OR: 0.995, P=0.005), orthopedic surgery classification (OR: 1.466, P<0.001) and postoperative D-dimer (OR:1.111, P=0.038). Conclusion Preoperative Hb and intraoperative autotransfusion volume were protective factors for allogeneic transfusion in elderly patients undergoing orthopedic surgery. History of cerebral infarction, intraoperative blood loss, orthopedic surgery classification (from low to high probability of transfusion) and postoperative D-dimer were the risk factors for allogeneic transfusion in elderly patients undergoing orthopedic surgery.

Key words: Senile fracture, Anemia, Transfusion management, Influence factors