The relationship between anemia at admission and outcome in patients older than 60 years with hip fracture

Tetsuo Hagino, Satoshi Ochiai, Eiichi Sato, Shingo Maekawa, Masanori Wako, Hirotaka Haro, Tetsuo Hagino, Satoshi Ochiai, Eiichi Sato, Shingo Maekawa, Masanori Wako, Hirotaka Haro

Abstract

Background: We have reported that the functional outcome in elderly with hip fracture is related to age at admission, dementia, and anemia. In this study, we examined the relationship between hemoglobin level at admission and walking ability, as well as survival outcome at discharge.

Materials and methods: We studied 394 patients aged 60 years or older treated at our hospital for hip fracture since 1997. Anemia was defined as an admission hemoglobin level <13.0 g/dl for men and <12.0 g/dl for women. The relationships between anemia status with age at admission, gender, fracture type, residence before injury, walking ability at discharge, length of hospital stay, and survival outcome were analyzed.

Results: Anemia was observed in 266 of 394 patients. Univariate analysis identified no relationship between the status of anemia and age, gender, walking ability before injury, treatment modality, or length of hospital stay. On the other hand, 106 of 266 patients in the anemic group were residing in institutions, and as many as 72.9% of patients in the anemic group had trochanteric fracture. For walking ability at discharge, 92 of 128 patients without anemia were ambulatory compared with only 130 of 266 patients with anemia, with a significant difference between the two groups. Furthermore, there were 15 in-hospital deaths in the anemic group compared with one death in the nonanemic group. Multivariate analysis identified three independent items: age, fracture type, and walking ability at discharge, as related to the status of anemia.

Conclusions: Hemoglobin level at admission is related to outcome in patients with hip fracture.

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1007/s00264-006-0086-y', 'is_inner': False, 'url': 'https://doi.org/10.1007/s00264-006-0086-y'}, {'type': 'PMC', 'value': 'PMC3172755', 'is_inner': False, 'url': 'http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3172755/'}, {'type': 'PubMed', 'value': '16552578', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/16552578/'}]}
    2. Hagino T, Sato E, Tonotsuka H, Ochiai S, Tokai M, Hamada Y (2006) Prediction of ambulation prognosis in the elderly after hip fracture. Int Orthop 30:315–319
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1007/s00402-007-0330-y', 'is_inner': False, 'url': 'https://doi.org/10.1007/s00402-007-0330-y'}, {'type': 'PubMed', 'value': '17492296', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/17492296/'}]}
    2. Hagino T, Ochiai S, Wako M, Sato E, Maekawa S, Senga S, Sugiyama H, Hamada Y (2007) A simple scoring system to predict ambulation prognosis after hip fracture in the elderly. Arch Orthop Trauma Surg 127:603–606
    1. None
    2. Muramoto A, Warashina H, Matsumoto T, Inoue H, Horii E, Osawa Y (2007) Predictors of mortality and functional recovery after hip fracture in elderly patients over 90 years old. J Jpn Orthop Assoc 81:S56
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/00005131-200407000-00007', 'is_inner': False, 'url': 'https://doi.org/10.1097/00005131-200407000-00007'}, {'type': 'PMC', 'value': 'PMC1454739', 'is_inner': False, 'url': 'http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1454739/'}, {'type': 'PubMed', 'value': '15213502', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/15213502/'}]}
    2. Halm EA, Wang JJ, Boockvar K, Penrod J, Silberzweig SB, Magaziner J, Koval KJ, Siu AL (2004) The effect of perioperative anemia on clinical and functional outcomes in patients with hip fracture. J Orthop Trauma 18:369–374
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/00005131-200201000-00009', 'is_inner': False, 'url': 'https://doi.org/10.1097/00005131-200201000-00009'}, {'type': 'PubMed', 'value': '11782632', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/11782632/'}]}
    2. Gruson KI, Aharonoff GB, Egol KA, Zuckerman JD, Koval KJ (2002) The relationship between admission hemoglobin level and outcome after hip fracture. J Orthop Trauma 16:39–44
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '18725664', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/18725664/'}]}
    2. Hagino T, Ochiai S, Wako M, Sato E, Maekawa S, Hamada Y (2008) Twin hook fixation for proximal femoral fractures. J Orthop Surg (Hong Kong) 16:162–164
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '17929715', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/17929715/'}]}
    2. Blom BJ, van Dis H, Simons MP, Willems WJ (2007) The relationship between surgical delay for a hip fracture and the complication risk. Ned Tijdschr Geneeskd 151:2050–2054
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1046/j.0041-1132.2003.00581.x', 'is_inner': False, 'url': 'https://doi.org/10.1046/j.0041-1132.2003.00581.x'}, {'type': 'PubMed', 'value': '14641869', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/14641869/'}]}
    2. Lawrence VA, Silverstein JH, Cornell JE, Pederson T, Noveck H, Carson JL (2003) Higher Hb level is associated with better early functional recovery after hip fracture repair. Transfusion 43:1717–1722
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1001/jama.279.3.199', 'is_inner': False, 'url': 'https://doi.org/10.1001/jama.279.3.199'}, {'type': 'PubMed', 'value': '9438739', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/9438739/'}]}
    2. Carson JL, Duff A, Berlin JA, Lawrence VA, Poses RM, Huber EC, O’Hara DA, Noveck H, Strom BL (1998) Perioperative blood transfusion and postoperative mortality. JAMA 279:199–205
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1007/s00776-003-0741-8', 'is_inner': False, 'url': 'https://doi.org/10.1007/s00776-003-0741-8'}, {'type': 'PubMed', 'value': '14767697', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/14767697/'}]}
    2. Committee for Osteoporosis Treatment of The Japanese Orthopaedic Association (2004) Nationwide survey of hip fractures in Japan. J Orthop Sci 9:1–5
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.jamda.2006.12.015', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.jamda.2006.12.015'}, {'type': 'PubMed', 'value': '17352999', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/17352999/'}]}
    2. Dharmarajan TS, Avula S, Norkus EP (2007) Anemia increases risk for falls in hospitalized older adults: an evaluation of falls in 362 hospitalized, ambulatory, long-term care, and community patients. J Am Med Dir Assoc 8:e9–e15
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '15530178', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/15530178/'}]}
    2. Dharmarajan TS, Norkus EP (2004) Mild anemia and the risk of falls in older adults from nursing homes and the community. J Am Med Dir Assoc 5:395–400

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