Cargando…

Effect of blood transfusion on survival after hip fracture surgery

BACKGROUND: Our primary goal was to audit the incidence of erythrocyte blood transfusion (EBT) after hip fracture surgery and study the effects on perioperative complications and early and late mortality. METHODS: In a retrospective cohort study all patients 65 years old and above treated operativel...

Descripción completa

Detalles Bibliográficos
Autores principales: Smeets, S. J. M., Verbruggen, J. P. A. M., Poeze, M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Paris 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132935/
https://www.ncbi.nlm.nih.gov/pubmed/29752534
http://dx.doi.org/10.1007/s00590-018-2205-z
_version_ 1783354419203538944
author Smeets, S. J. M.
Verbruggen, J. P. A. M.
Poeze, M.
author_facet Smeets, S. J. M.
Verbruggen, J. P. A. M.
Poeze, M.
author_sort Smeets, S. J. M.
collection PubMed
description BACKGROUND: Our primary goal was to audit the incidence of erythrocyte blood transfusion (EBT) after hip fracture surgery and study the effects on perioperative complications and early and late mortality. METHODS: In a retrospective cohort study all patients 65 years old and above treated operatively for an acute hip fracture were included over a 48-month period with a 2-year follow-up period. Postoperative hemoglobin levels were used to investigate at what threshold EBT was used. The relation between EBT and perioperative complications and survival was analyzed with multivariate regression analysis. A propensity score for predicting the chance of receiving an EBT was calculated and used to differentiate between transfusion being a risk factor for mortality and other related confounding risk factors. Mortality was subdivided as in-hospital, 30-day, 1-year and 2-year mortality. RESULTS: Of the 388 included patients, 41% received a blood transfusion. The postoperative hemoglobin level was the strongest predictor for EBT. Patients who received EBT had a significant longer hospital stay and more postoperative cardiac complications, even after adjustment for confounders. Multivariate analysis for mortality showed that EBT was a significant risk factor for early as well as late mortality, but after adding the propensity score, EBT was no longer associated with increased mortality. CONCLUSION: There was no effect of EBT on mortality after correction with propensity scoring for predictors of EBT. Transfusion in patients treated operatively for hip fracture should be evenly matched with their cardiovascular risk during the perioperative phase.
format Online
Article
Text
id pubmed-6132935
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Springer Paris
record_format MEDLINE/PubMed
spelling pubmed-61329352018-09-13 Effect of blood transfusion on survival after hip fracture surgery Smeets, S. J. M. Verbruggen, J. P. A. M. Poeze, M. Eur J Orthop Surg Traumatol Original Article • HIP - ANESTHESIA BACKGROUND: Our primary goal was to audit the incidence of erythrocyte blood transfusion (EBT) after hip fracture surgery and study the effects on perioperative complications and early and late mortality. METHODS: In a retrospective cohort study all patients 65 years old and above treated operatively for an acute hip fracture were included over a 48-month period with a 2-year follow-up period. Postoperative hemoglobin levels were used to investigate at what threshold EBT was used. The relation between EBT and perioperative complications and survival was analyzed with multivariate regression analysis. A propensity score for predicting the chance of receiving an EBT was calculated and used to differentiate between transfusion being a risk factor for mortality and other related confounding risk factors. Mortality was subdivided as in-hospital, 30-day, 1-year and 2-year mortality. RESULTS: Of the 388 included patients, 41% received a blood transfusion. The postoperative hemoglobin level was the strongest predictor for EBT. Patients who received EBT had a significant longer hospital stay and more postoperative cardiac complications, even after adjustment for confounders. Multivariate analysis for mortality showed that EBT was a significant risk factor for early as well as late mortality, but after adding the propensity score, EBT was no longer associated with increased mortality. CONCLUSION: There was no effect of EBT on mortality after correction with propensity scoring for predictors of EBT. Transfusion in patients treated operatively for hip fracture should be evenly matched with their cardiovascular risk during the perioperative phase. Springer Paris 2018-05-11 2018 /pmc/articles/PMC6132935/ /pubmed/29752534 http://dx.doi.org/10.1007/s00590-018-2205-z Text en © The Author(s) 2018 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.
spellingShingle Original Article • HIP - ANESTHESIA
Smeets, S. J. M.
Verbruggen, J. P. A. M.
Poeze, M.
Effect of blood transfusion on survival after hip fracture surgery
title Effect of blood transfusion on survival after hip fracture surgery
title_full Effect of blood transfusion on survival after hip fracture surgery
title_fullStr Effect of blood transfusion on survival after hip fracture surgery
title_full_unstemmed Effect of blood transfusion on survival after hip fracture surgery
title_short Effect of blood transfusion on survival after hip fracture surgery
title_sort effect of blood transfusion on survival after hip fracture surgery
topic Original Article • HIP - ANESTHESIA
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132935/
https://www.ncbi.nlm.nih.gov/pubmed/29752534
http://dx.doi.org/10.1007/s00590-018-2205-z
work_keys_str_mv AT smeetssjm effectofbloodtransfusiononsurvivalafterhipfracturesurgery
AT verbruggenjpam effectofbloodtransfusiononsurvivalafterhipfracturesurgery
AT poezem effectofbloodtransfusiononsurvivalafterhipfracturesurgery