Factors associated with transfusion in anesthesia for orthopedic surgery in elderly patients in a resource-limited setting.
Abstract
Background and objective. Orthopedic surgery in elderly patients is often associated with significant blood loss, exposing these patients to a high risk of transfusion. This study investigated the frequency and factors associated with transfusion in elderly orthopedic surgical patients in a resource-limited setting.
Methodology. This is a retrospective cohort study conducted at Monkole Hospital Centre from January 2011 to December 2024. It included all patients aged 60 years or older who underwent anesthesia for orthopedic surgery. The sample used was exhaustive, based on patient records. Peri-anesthetic data were collected in accordance with ethical guidelines until discharge from hospital and analyzed using SPSS 26.0 for P < 0.05.
Results. The study included 168 patients, representing 17.19% of elderly patients and 1.27% of all patients. Thirty-four patients (20.2%) received transfusions. The mean age was 68.7 years, with no significant difference according to transfusion status. Similarly, the anesthetic technique did not influence the need for transfusion. Factors independently associated with transfusion were hemoglobin ≤10 g/dl, ASA III-IV status, intraoperative incidents, major surgery, operative time ≥2 hours, conjunctival pallor and frailty/dependence. Conversely, alcohol consumption appeared to be a protective factor.
Conclusion. These results confirm the central role of preoperative optimization and intraoperative vigilance in reducing transfusion requirements. The integration of ‘Patient Blood Management’ strategies and surgical and anesthetic techniques aimed at limiting blood loss appear to be essential.
Keywords: Anesthesia; Orthopedic surgery; Patient Blood Management; Resource-limited countries; Transfusion
Citation: Kintieti P, Mbombo W, Mosolo A, Bunkete AM, Naturoyila AN. Factors associated with transfusion in anesthesia for orthopedic surgery in elderly patients in a resource-limited setting. Anaesth. pain intensive care 2025;30(2):175-183. DOI: 10.35975/apic.v30i2.3123
Received: September 16, 2025; Revised: October 11, 2025; Accepted: December 14, 2025
