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A restrictive policy for red blood cell transfusion in older hip fracture patients: experiences from a patient register
BACKGROUND: Allogeneic red blood cell transfusions (ABT) are common in older hip fracture patients. Recent research supports a restrictive transfusion policy. The aim was to study variation in hemoglobin (Hb) concentration, and clinical outcomes in these patients. RESULTS: Cross-sectional study with...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746927/ https://www.ncbi.nlm.nih.gov/pubmed/26860849 http://dx.doi.org/10.1186/s13104-016-1885-x |
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author | Martinsen, Mette Irene Valland, Haldor Solheim, Ludvig Fjeld Holvik, Kristin Ranhoff, Anette |
author_facet | Martinsen, Mette Irene Valland, Haldor Solheim, Ludvig Fjeld Holvik, Kristin Ranhoff, Anette |
author_sort | Martinsen, Mette Irene |
collection | PubMed |
description | BACKGROUND: Allogeneic red blood cell transfusions (ABT) are common in older hip fracture patients. Recent research supports a restrictive transfusion policy. The aim was to study variation in hemoglobin (Hb) concentration, and clinical outcomes in these patients. RESULTS: Cross-sectional study with one-year follow-up in an orthogeriatric unit. Data were obtained from a quality register with demographic and medical information collected by an interdisciplinary team. 106 (22 %) of the 491 patients admitted from September 2011 throughout September 2012 (76 % women, mean age 85 years) received ABT. When given ABT, 80 % had Hb <80 g/l and mean Hb was 78 g/l. Mean Hb, regardless ABT, showed variation from 125 g/l (±16) on admission to 106 g/l (±17), 101 g/l (±16) and 102 g/l (±14) on 1st, 3rd and 5th postoperative day respectively. Patients with per-/subtrochanteric fractures more often received ABT than those with femur neck fractures (p < 0.001), 70 % of the patients receiving ABT had a per-/subtrochanteric fracture. Patients who received ABT were older, had more chronic diseases and lower mean Hb throughout the hospital stay. Length of stay was longer (median 7 vs. 6 days, p = 0.01), and medical complications more common. In-hospital and 30-day mortalities were similar in patients given ABT and in those who were not, but 1-year mortality was higher among patients who were given ABT (p = 0.008). CONCLUSIONS: Hb had a tendency to fall during the three first days after surgery and seemed to be stabilized on day 5. Patients who received ABT had poorer health, but not significantly higher short-term mortality. This study demonstrates a restrictive transfusion policy. |
format | Online Article Text |
id | pubmed-4746927 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47469272016-02-10 A restrictive policy for red blood cell transfusion in older hip fracture patients: experiences from a patient register Martinsen, Mette Irene Valland, Haldor Solheim, Ludvig Fjeld Holvik, Kristin Ranhoff, Anette BMC Res Notes Short Report BACKGROUND: Allogeneic red blood cell transfusions (ABT) are common in older hip fracture patients. Recent research supports a restrictive transfusion policy. The aim was to study variation in hemoglobin (Hb) concentration, and clinical outcomes in these patients. RESULTS: Cross-sectional study with one-year follow-up in an orthogeriatric unit. Data were obtained from a quality register with demographic and medical information collected by an interdisciplinary team. 106 (22 %) of the 491 patients admitted from September 2011 throughout September 2012 (76 % women, mean age 85 years) received ABT. When given ABT, 80 % had Hb <80 g/l and mean Hb was 78 g/l. Mean Hb, regardless ABT, showed variation from 125 g/l (±16) on admission to 106 g/l (±17), 101 g/l (±16) and 102 g/l (±14) on 1st, 3rd and 5th postoperative day respectively. Patients with per-/subtrochanteric fractures more often received ABT than those with femur neck fractures (p < 0.001), 70 % of the patients receiving ABT had a per-/subtrochanteric fracture. Patients who received ABT were older, had more chronic diseases and lower mean Hb throughout the hospital stay. Length of stay was longer (median 7 vs. 6 days, p = 0.01), and medical complications more common. In-hospital and 30-day mortalities were similar in patients given ABT and in those who were not, but 1-year mortality was higher among patients who were given ABT (p = 0.008). CONCLUSIONS: Hb had a tendency to fall during the three first days after surgery and seemed to be stabilized on day 5. Patients who received ABT had poorer health, but not significantly higher short-term mortality. This study demonstrates a restrictive transfusion policy. BioMed Central 2016-02-09 /pmc/articles/PMC4746927/ /pubmed/26860849 http://dx.doi.org/10.1186/s13104-016-1885-x Text en © Martinsen et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Short Report Martinsen, Mette Irene Valland, Haldor Solheim, Ludvig Fjeld Holvik, Kristin Ranhoff, Anette A restrictive policy for red blood cell transfusion in older hip fracture patients: experiences from a patient register |
title | A restrictive policy for red blood cell transfusion in older hip fracture patients: experiences from a patient register |
title_full | A restrictive policy for red blood cell transfusion in older hip fracture patients: experiences from a patient register |
title_fullStr | A restrictive policy for red blood cell transfusion in older hip fracture patients: experiences from a patient register |
title_full_unstemmed | A restrictive policy for red blood cell transfusion in older hip fracture patients: experiences from a patient register |
title_short | A restrictive policy for red blood cell transfusion in older hip fracture patients: experiences from a patient register |
title_sort | restrictive policy for red blood cell transfusion in older hip fracture patients: experiences from a patient register |
topic | Short Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746927/ https://www.ncbi.nlm.nih.gov/pubmed/26860849 http://dx.doi.org/10.1186/s13104-016-1885-x |
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