Feasibility of Hip Fracture Surgery Using a No Transfusion Protocol in Elderly Patients: A Propensity Score-Matched Cohort Study. Issue 8 (August 2017)

• Record Type: Journal Article
• Authors: Yoon, Byung-Ho; Ko, Young Seung; Jang, Suk-Hwan; Ha, Jeong Ku
• Is Part Of: Journal of orthopaedic trauma. Volume 31:Issue 8(2017)
• Publication Date: 2017-08
• Subjects: hip fracture -- allogeneic blood transfusion -- mortality -- complication -- propensity score matching; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000000870
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To determine whether hip fracture surgery (HFS) without transfusion affects postoperative mortality and complications in elderly patients. Design: Retrospective comparative study. Patients: Three hundred fourteen patients ≥65 years of age who underwent HFS between May 2003 and December 2014. Patients were divided into 2 groups: those who consented to blood transfusion if needed and those who did not. One-to-one propensity score matching generated 50 matched pairs of patients. Intervention: Patients underwent HFS with or without blood transfusion. In the no transfusion group, simultaneous administration of erythropoietin and iron was used as an alternative. Main Outcome Measurements: The primary outcome was postoperative mortality (90-day, 1-year, overall). The secondary outcomes were hemoglobin change and the incidence of postoperative complications. Results: HFS using a no transfusion protocol was not associated with increased mortality at any time point. Mean hemoglobin levels were significantly different between the 2 groups on postoperative day 1 (11.0 ± 1.3 vs. 10.5 ± 1.6, P = 0.002) but levels completely recovered within 2 weeks in both groups. There was also no difference in postoperative complication rates between the 2 groups, and overall hospital stays and charges were similar. Conclusions: An HFS protocol without blood transfusion was not associated with increased mortality or complications in elderly patients. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. Abstract : Supplemental Digital Content is Available in the Text.