On admission haemoglobin in patients with hip fracture

Kumar, Devinder; Mbako, Aloysius; Riddick, Andrew; Patil, Supriya; Williams, Philippa

doi:10.1016/j.injury.2010.07.239

Cited by 61 publications

(45 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study, men were less likely than women to undergo surgery on the day of admission or on the following day. Surgery is often postponed to stabilize patients' clinical condition and optimize their hemodynamic status, since most patients admitted after a PFF are clinically unstable, dehydrated, anemic, and malnourished 36 . In addition, patients on antithrombotic medication prior to the fracture (highly common in the elderly for preventing thrombosis and atrial fibrillation) normally have their surgery delayed to prevent excessive intraoperative bleeding 37,38 .…”

Section: Discussionmentioning

confidence: 99%

Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in Portugal

et al. 2015

View full text Add to dashboard Cite

Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in PortugalTempo até a morte após fratura do fêmur proximal: uma coorte prospectiva de 252 doentes tratados no segundo maior hospital em Portugal Tiempo transcurrido hasta la muerte después de una fractura de cadera: una cohorte prospectiva de 252 pacientes del segundo mayor hospital de Portugal

show abstract

Section: Discussionmentioning

confidence: 99%

Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in Portugal

et al. 2015

View full text Add to dashboard Cite

show abstract

“…depending on the fracture type [73,74]. The lower a patient's haemoglobin concentration before hip fracture, the more likely they are to be transfused [42,75].…”

mentioning

confidence: 99%

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

2015

View full text Add to dashboard Cite

SummaryWe systematically reviewed the observational associations of anaemia with outcomes and the effects of interventions to increase haemoglobin concentrations following hip fracture in older people. Anaemia on hospital admission was associated with increased mortality, relative risk 1.64 (95% CI 1.47-1.82), p < 0.0001. After adjustment for co-morbidities, the association of anaemia with increased mortality remained in four of eight observational studies. There was no association of postoperative transfusion with mortality after adjusting for covariates. Transfusion at 80 g.l À1 vs 100 g.l À1 increased acute myocardial infarction, relative risk 1.67 (95% CI 1.01-2.77), p = 0.05. Transfusion threshold was not associated with differences in other outcomes. There were insufficient high-quality studies to inform pre-operative blood transfusion or the use of peri-operative iron or erythropoietin. Studies for most interventions recruited too few participants to determine effects on infections, mortality or function.

show abstract

“…Kumar et al showed that the average haemoglobin concentration fell by 2.23 g/dL in subtrochanteric fractures, 1.1 g/dL in intertrochanteric fractures and 0.7 g/dL in intracapsular fractures following admission but before surgery. Foss et al suggested that this only worsens with treatment due to blood loss during hip fracture surgery ranging from 547 to 1473 mL 27 28. Irrison et al showed that the haemoglobin concentration follows a linear decline in the first 3 days postoperatively, suggesting that measuring haemoglobin concentration 24 hours will not detect incomplete postoperative resuscitation 29…”

Section: Resultsmentioning

confidence: 99%

Resuscitation in hip fractures: a systematic review

2017

View full text Add to dashboard Cite

To evaluate the evidence for the resuscitation of patients with hip fracture in the preoperative or perioperative phase of their treatment and its impact on mortality.DesignWe searched MEDLINE, EMBASE, CENTRAL and PROSPERO databases using a systematic search strategy for randomised trials and observational studies investigating the fluid resuscitation of any patient with hip fracture. No language limits were applied to the search, which was complemented by manually screening the reference lists of appropriate studies.Outcome measuresMortality at 1 week, 30 days and 1 year following surgery.ResultsTwo hundred and ninety-eight citations were identified, and 12 full manuscripts were reviewed; no studies satisfied the inclusion criteria. The background literature showed that the mortality for these patients at 30 days is approximately 8.5% and that bone cement implantation syndrome is insufficient to explain this. The literature was explored to define the need for an interventional investigation into the preoperative resuscitation of patients with hip fracture.ConclusionsPatients with hip fracture show similar physiological disturbance to major trauma patients. Nineteen per cent of patients presenting with hip fracture are hypoperfused and 50% show preoperative anaemia suggesting that under resuscitation is a common problem that has not been investigated. A properly conducted interventional trial could improve the outcome of these vulnerable patients.

show abstract

On admission haemoglobin in patients with hip fracture

Cited by 61 publications

References 28 publications

Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in Portugal

Time to death in a prospective cohort of 252 patients treated for fracture of the proximal femur in a major hospital in Portugal

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

Resuscitation in hip fractures: a systematic review

Contact Info

Product

Resources

About