91.
Factors associated with red blood cell transfusion in patients with a
fractured hip
Christian Medom Madsen, Astrid Norgaard, Troels Riis, Ole Birger Pedersen,
Benn Duus, Jes Bruun Lauritzen
Department of Orthopaedic Surgery Bispebjerg University Hospital; Sections
for Transfusion Medicine, Rigshospitalet Copenhagen University Hosptial;
Department of Orthopaedic Surgery, Bispebjerg University Hospital;
Department of Clinical Immunology, Naestved Hospital; Department of
Orthopaedic Surgery, Bispebjerg University Hospital; Department of
Orthopaedic Surgery, Bispebjerg University Hospital
Background:
Red blood cell (RBC) transfusion in patients admitted with hip
fractures remains an area of debate, with a recent large-scale multicenter RCT
failing to demonstrate the benefit of liberal transfusion (Carson JL et al, 2011).
Purpose / Aim of Study:
To determine the factors associated with transfusion
in hip fracture patients.
Materials and Methods:
817
consecutive hip fracture patients (>75years)
admitted from 01.09.2008 to 30.11.2010 were included in this study. Data was
retrieved from our hip fracture database. Data on transfusion was retrieved
from the Capital Region Blood Bank database. Comparison between groups
was done by univariable and multivariable analyses in SAS.
Findings / Results:
533
patients (65.2%) received one or more RBC
transfusions. The transfused group included significantly more women (80.7%
vs. 69.4%, p=0.0003) and had a higher mean age (87.4 years vs. 84.7 years,
p<0.0001) than the non-transfused group. The multivariable analysis including
the variables age, gender, residence, ASA score, alcohol and type of fracture,
showed that increasing age (OR 1.08 [1.05-1.11]), female sex (OR 1.55 [1.05-
2.29]),
own home (OR 1.56 [1.03- 2.36]), ASA >2 (OR 1.41 [1.07-1.86]), and
extracapsular fractures (OR 2.04 [1.46-2.84]) were all associated with
transfusion following hip fracture. Alcohol consumption was not (OR 0.86
[0.44-1.67]).
Conclusions:
Age, gender, ASA score, residence and fracture type were all
independently associated with transfusion. The transfusion rate was high in
this group of patients.
