Blood transfusion rates and predictors following geriatric hip fracture surgery

Arshi, Armin; Lai, Wilson C; Iglesias, Brenda; McPherson, Edward J.; Zeegen, Erik N.; Stavrakis, Alexandra I.; Sassoon, Adam

doi:10.1177/1120700019897878

Cited by 66 publications

(73 citation statements)

References 35 publications

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“…These risk factors associated with the poor prognosis after hip fracture has been confirmed in the previous studies [30,31]. Although blood transfusion was associated with mortality after hip fracture in some studies [32,33], no such relationship was found in our data. We speculated that the possible reason was that the number of patients receiving blood transfusion were small (n = 84 in our study), which may influence this relationship.…”

Section: Discussionsupporting

confidence: 86%

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Wang¹,

Wang²,

Yang³

et al. 2020

International Orthopaedics (SICOT)

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Purpose The platelet-to-lymphocyte ratio (PLR) has been extensively studied in various diseases. However, the relationship between PLR and hip fracture remains unknown. The aim of this study was to evaluate whether PLR would be an independent prognostic factor in elderly hip fracture patients. Methods Between January 2014 and December 2018, a retrospective cohort study was conducted in a orthopaedic centre, China. A total of 460 hip fracture patients were included. PLR was calculated as the ratio of platelet to lymphocyte counts and divided into high PLR group (≥ 189) and low PLR group (< 189) by using the receiver operating characteristic (ROC) curve. The relationship between PLR and one year all-cause mortality rate was assessed by univariate and multivariate Cox proportional hazard models. Further subgroup analysis stratified by different clinical and biological characteristics was performed to make the results more accurate. Results After a median follow-up of 32.0 months (range, 12.0-75.4), 92 patients (mortality rate: 20.0%) died within one year. PLR was significantly higher in dead patients compared with alive patients (p < 0.05), and high PLR group also had a high mortality rate (32.21% vs. 14.15%, p < 0.001). After multivariate adjustment, high PLR remained an independent predictor for one year all-cause mortality (adjusted hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.02-2.41, p = 0.041). Moreover, advanced age (HR 1.05, 95% CI 1.01-1.08), male (HR 1.62, 95% CI 1.06-2.45), CCI ≥ 2 (HR 2.83, 95% CI 1.64-4.89), conservative treatment (HR 5.94, 95% CI 3.71-9.73), low haemoglobin level (HR 1.02, 95% CI 1.01-1.04), and low albumin level (HR 1.07, 95% CI 1.02-1.13) were independent risk factors for survival. Furthermore, subgroup analysis results were consistent with the main findings in most stratified groups. Conclusion This study highlights that high PLR (≥ 189) is associated with increased one year all-cause mortality in elderly hip fracture patients. As PLR is a simple indicator that can be calculated from the blood routine test, it can be easily performed in usual clinical practice.

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Section: Discussionsupporting

confidence: 86%

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Wang¹,

Wang²,

Yang³

et al. 2020

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…In this study, the preoperative Hb of the blood transfusion group was (113.9 ± 14.0) g/L, which was signi cantly lower than the preoperative Hb (128.2 ± 12.8) g/L of the non-transfusion group (p < 0.05). This result is consistent with many previous studies [7,9,13] . Adunsky A et al [14] found that patients with preoperative Hb lower than 120 g/L have a 5-fold increase in the risk of postoperative blood transfusion.…”

Section: Discussionsupporting

confidence: 94%

Allogeneic Red Blood Cell Transfusion Rate and Risk Factors in Elderly Patients With Femoral Neck Fracture After Hemiarthroplasty

Yue

Yang

Deng

et al. 2020

Preprint

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Objective: To determine the rate and risk factors of allogeneic red blood cell transfusions (ABT) in elderly patients with femoral neck fracture (FNF) after hemiarthroplasty (HA). Methods: We conducted a study on elderly patients (≥65 years old) who were admitted to the geriatric trauma orthopedics ward of Beijing Jishuitan Hospital for HA treatment from March 2018 to February 2019 due to FNF. The perioperative data were collected retrospectively, and univariate and multivariate stepwise logistic regression analysis were performed to determine the postoperative ABT rate and its risk factors. Results: 343 patients were included in the study, of which 151 (44.0%) received ABT after surgery. Multivariate stepwise logistic regression analysis showed that preoperative low hemoglobin (Hb), high intraoperative blood loss (IBL), advanced age, and low body mass index (BMI) are independent risk factors of ABT after HA in elderly FNF patients. Conclusion: ABT after HA is a common phenomenon in elderly patients with FNF. Their postoperative ABT needs are related to preoperative low Hb, high IBL, advanced age, and low BMI. Therefore, ABT can be reduced from the above aspects.

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“…In this study, the preoperative Hb of the blood transfusion group was (113.18 ± 14.69) g/L, which was signi cantly lower than the preoperative Hb (128.80 ± 12.41) g/L of the nontransfusion group (p < 0.05). This result is consistent with many previous studies [7,9,13] . Adunsky A et al [14] found that patients with preoperative Hb lower than 120 g/L have a 5-fold increase in the risk of postoperative blood transfusion.…”

Section: Discussionsupporting

confidence: 94%

“…Consistent with previous studies [7,13] , we found that advanced age is an independent risk factor for ABT in elderly FNF patients after HA. This may be related to the lower baseline Hb of older people.…”

Section: Discussionsupporting

confidence: 93%

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Allogeneic Red Blood Cell Transfusion Rate and Risk Factors in Elderly Patients with Femoral Neck Fracture after Hemiarthroplasty

Yue

Yang

Deng

et al. 2020

Preprint

View full text Add to dashboard Cite

Objective: To determine the rate and risk factors of allogeneic red blood cell transfusions (ABT) in elderly patients with femoral neck fracture (FNF) after hemiarthroplasty (HA). Methods: We conducted a study on elderly patients (≥65 years old) who were admitted to the geriatric trauma orthopedics ward of Beijing Jishuitan Hospital for HA treatment from March 2018 to February 2019 due to FNF. The perioperative data were collected retrospectively, and univariate and multivariate stepwise logistic regression analysis were performed to determine the postoperative ABT rate and its risk factors. Results: 445 patients were included in the study, of which 177 (39.8%) received ABT after surgery. Multivariate stepwise logistic regression analysis showed that preoperative low hemoglobin (Hb), high intraoperative blood loss (IBL), advanced age, and low body mass index (BMI) are independent risk factors of ABT after HA in elderly FNF patients. Conclusion: ABT after HA is a common phenomenon in elderly patients with FNF. Their postoperative ABT needs are related to preoperative low Hb, high IBL, advanced age, and low BMI. Therefore, ABT can be reduced from the above aspects.

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Blood transfusion rates and predictors following geriatric hip fracture surgery

Cited by 66 publications

References 35 publications

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

Allogeneic Red Blood Cell Transfusion Rate and Risk Factors in Elderly Patients With Femoral Neck Fracture After Hemiarthroplasty

Allogeneic Red Blood Cell Transfusion Rate and Risk Factors in Elderly Patients with Femoral Neck Fracture after Hemiarthroplasty

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