Blood transfusion in proximal humerus fractures.

This article is the first to specifically address blood transfusions associated with surgical treatment of proximal humerus fractures. In our study, we retrospectively reviewed charts of all patients admitted to our institution with a diagnosis of proximal humerus fracture from January 1, 1994, to December 31, 1997. The transfusion rate for patients who sustained a proximal humerus fracture was 15%. Compared with patients treated nonoperatively, patients who underwent a surgical procedure were not at increased risk for requiring transfusion. Age, hematocrit level on admission, treatment method, and estimated amount of blood loss in patients who underwent a surgical procedure varied significantly between those who received a transfusion and those who did not. Certain characteristics placed patients at increased risk for requiring transfusion-age older than 60, admission hematocrit level less than 33%, and hemiarthroplasty as definitive surgical treatment. This information is important both in educating patients and their families and in making management decisions.