Is anemia at admission related to short-term outcomes of elderly hip fracture patients?

Abstract

<jats:title>Abstract</jats:title><jats:p>Hip fracture in elderly people is associated with high morbidity and mortality. Therefore, it is important to identify risk factors that potentially influence outcomes after hip surgery. The main purpose of this study was to evaluate the relationship of anemia at admission and short-term outcomes after hip fracture. We studied 343 community-dwelling patients who underwent surgery for hip fracture from March 2009 to March 2010. Functional mobility at discharge, postoperative complications, hospital length of stay and in-hospital mortality were analyzed in respect to presence and severity of anemia at admission. Anemia (defined as hemoglobin levels &lt; 13.0 g/dl for men and &lt; 12.0g/dl for women) was present in 185 (53.9%) patients, of whom 54 (29.2%) were severely anemic (defined as hemoglobin level 10.0g/dl or below). In multivariate analysis anemia was associated with age, gender (female), type of fracture (intertrochanteric) and American Society of Anesthesiologists (ASA) classification (3 or 4), while severity of anemia was associated with recovery of ambulatory ability at discharge. There was no difference in the incidence of postoperative complication, in-hospital mortality and length of hospital stay between the groups at discharge. Overall anemia at admission is an indicator of poor general health status. Ambulatory recovery in hip fracture patients is independently related to severity of anemia at admission.</jats:p>

A systematic review of pre-operative anaemia and blood transfusion in patients with fractured hips

“…Anaemia on admission was associated with increased mortality [17,18,20,22,25,27,28,33,36,40] at all time points beyond 30 days (Fig. 3), whether the anaemia was mild (Fig.…”

“…Four other studies reported statistically significant associations between pre-operative anaemia and mortality that we could not include in the meta-analysis [16,30,34,37]. The data for hospital length of stay, reported by seven studies, were unsuitable for meta-analysis [19,20,22,27,29,40,41]. Six studies found no association between admission anaemia and length of stay [19,20,22,29,40,41] and one reported that anaemia was associated with increased stays [27].…”

“…The data for hospital length of stay, reported by seven studies, were unsuitable for meta-analysis [19,20,22,27,29,40,41]. Six studies found no association between admission anaemia and length of stay [19,20,22,29,40,41] and one reported that anaemia was associated with increased stays [27]. Readmission to hospital was associated with anaemia in one study, up to 90 days after discharge [40], but anaemia was not associated with readmission up to 28 days after discharge in a second study [35].…”

“…Readmission to hospital was associated with anaemia in one study, up to 90 days after discharge [40], but anaemia was not associated with readmission up to 28 days after discharge in a second study [35]. Three studies reported no association of anaemia with postoperative complications [19,20,22] and one did [21]. Two studies reported an association between anaemia and reduced function [20,29], but two studies did not when adjusted for other factors [27,30].…”

“…Three studies reported no association of anaemia with postoperative complications [19,20,22] and one did [21]. Two studies reported an association between anaemia and reduced function [20,29], but two studies did not when adjusted for other factors [27,30]. One study found no association between admission anaemia and functional recovery up to one year after hospital admission [22].…”