Author(s): Naraen S.; Burke D.; Pemble I.; Middleton S.; Ward O.; Temperton A.; Baird S.; Torrance R.; Maddison A.; Austin G.; Davis H.; Sameul M.; Brezezinska M.; Shamim S.; Isaac L.; Attwood J.; Lee S.; Khare A.

Source: Osteoporosis International; 2018; vol. 29 (no. 1)

Publication Date: 2018

Publication Type(s): Conference Abstract

Available  at Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA –  from SpringerLink – Medicine

Abstract:Objective:Anaemia following hip fracture is common. On admission 30- 45%patients are anaemic. The cause of anaemia in older patients with hip fracture is multifactorial. 20% of women between 80-85 years have anaemia of chronic disease. These patients represent the majority of the hip fracture population. Combined with intraoperative blood loss, it could result in further anaemia.We investigated the factors contributing to postsurgical anemia. This study looked into the preoperative medication, comorbidities and postoperative complications at a teaching hospital over one year to. Method: Data were collected for patients with a fractured neck of femur (NOF) followed by surgical correction between 1 January 2016 and 1 January 2017. 328 patients were studied. Preoperative and postoperative factors which could influence the fall in haemoglobin level were studied. Results: 229 patients admitted with NOF were female and 144 of these were aged between 81-90 years. The majority of surgeries were done within 48 h. Preoperative anaemia was found in 45% (n=149). 3% (n=9) required preoperative transfusion and 9%(n=21) were on nutritional supplements. Preoperative haematinics were done in 2% (n=5). 95% (n=314) developed postoperative anaemia and 38% (n=126) had a haemoglobin between 70-90 mg/L. Of the 90 patients who were on anti- platelet therapy, 56 (62%) went to develop postoperative anaemia. Of the 48 patient that were on anticoagulants, 18 (33%) went on to develop postoperative anaemia. Volume loss intraoperatively was recorded in 3% (n=9). 39 of 328 (12%) patients had a haemoglobin between 50-60 mg/L, that was the lowest range recorded in the sample. Of the 149 patients with preoperative anaemia, 46% required postoperative blood transfusion. Of the 328 patients, 96 (29%) were given a blood transfusion postoperatively. 31% (n=101) had postoperative infection and of these, 46% (n=46) had postoperative anaemia. Conclusion: Postoperative anaemia was found in 95% of sample. 29% required a blood transfusion. Preoperative anaemia played a large role in the need of a postoperative blood transfusion. Intraoperative blood loss, medication and postoperative complications also contributed to postoperative anaemia.

Database: EMBASE