Postoperative Hemoglobin Drop and the Associated Factors among Elective Orthopedic Surgeries in Northern Tanzania

Abstract

Background. Having an estimated level of Hb drop in different orthopedic surgeries would help plan for surgery from pre- to postoperative periods. The aim of this study was to assess the Hb drop and the associated factors during the intraoperative period among elective orthopedic surgeries. Methods. This was an analytic cross-sectional study conducted between October 2022 and March 2023, which included all patients admitted for elective orthopedic surgery who met the inclusion criteria. Data were collected before and after the patient was operated on. Information was analyzed using t-tests and ANOVA to establish the statistical significance of the Hb drop. Results. A total of 195 participants were enrolled. The majority of the participants were male (62.1%), with the main etiology of symptoms being motor traffic accidents (31.8%). The most affected site was the femur (36.4%), followed by the spine (23.6%). The highest mean Hb drop was in total hip replacement surgeries (4.19 g/dL), with the overall mean Hb drop being 2.75 g/dL. A statistically significant difference was identified in diathermy use, duration of surgery, and patients with chronic illnesses. Conclusion. With a mean Hb drop of 2.75 g/dL, the application of diathermy and surgeries with shorter durations resulted in a reduced Hb drop. These factors should be incorporated to minimize the drop in Hb in orthopedic surgeries. Accounting for differences in surgeries, there should not be delays in patients who have a preoperative Hb level that can sustain the mean Hb drop recorded in the study.