Effect of Blood Transfusion on Survival After Hip Fracture Surgery

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2018 May 13

PMID 29752534

Citations 25

Authors

S J M Smeets

J P A M Verbruggen

M Poeze

Affiliations

Soon will be listed here.

Abstract

Background: Our primary goal was to audit the incidence of erythrocyte blood transfusion (EBT) after hip fracture surgery and study the effects on perioperative complications and early and late mortality.

Methods: In a retrospective cohort study all patients 65 years old and above treated operatively for an acute hip fracture were included over a 48-month period with a 2-year follow-up period. Postoperative hemoglobin levels were used to investigate at what threshold EBT was used. The relation between EBT and perioperative complications and survival was analyzed with multivariate regression analysis. A propensity score for predicting the chance of receiving an EBT was calculated and used to differentiate between transfusion being a risk factor for mortality and other related confounding risk factors. Mortality was subdivided as in-hospital, 30-day, 1-year and 2-year mortality.

Results: Of the 388 included patients, 41% received a blood transfusion. The postoperative hemoglobin level was the strongest predictor for EBT. Patients who received EBT had a significant longer hospital stay and more postoperative cardiac complications, even after adjustment for confounders. Multivariate analysis for mortality showed that EBT was a significant risk factor for early as well as late mortality, but after adding the propensity score, EBT was no longer associated with increased mortality.

Conclusion: There was no effect of EBT on mortality after correction with propensity scoring for predictors of EBT. Transfusion in patients treated operatively for hip fracture should be evenly matched with their cardiovascular risk during the perioperative phase.

Citing Articles

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Predictors for 1-year mortality in geriatric patients following fragile intertrochanteric fracture surgery.

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Relationship between preoperative hemoglobin levels and length of stay in elderly patients with hip fractures: A retrospective cohort study.

Zhang N, Zhang D, Ren S, Gao Y, Sun W, Yang S Medicine (Baltimore). 2024; 103(25):e38518.

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Development and validation of models for predicting mortality in intertrochanteric fracture surgery patients with perioperative blood transfusion: a prospective multicenter cohort study.

Guo J, Geng Q, Xu K, Jing W, Li Z, He J Int J Surg. 2024; 110(8):4754-4766.

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