Randomised trial of blood transfusion versus a restrictive transfusion policy after hip fracture surgery
Section snippets
Patients and methods
Patients treated at a single centre with a proximal femoral (hip) fracture were considered for inclusion in the study if their haemoglobin measured on the first or second day after surgery was between 8.0 and 9.5 g dl−1 and no definite symptoms of anaemia were present. Patients with haemoglobin of <8.0 g dl−1 were not included and received a blood transfusion and those with haemoglobin >9.5 g dl−1 were not transfused. Exclusion criteria were age <60 years, patients unwilling or unable to provide
Results
Table 1 details the characteristics of the patients included in the study. Both groups of patients were comparable with no statistically significant difference between the two groups. All the patients who did not receive general anaesthesia had regional anaesthesia. All patients in the transfusion group received a blood transfusion with a mean of 1.9 U of blood (16 patients received one unit, 92 two units, one three units and four patients received four units). Eleven patients allocated to the
Discussion
This study showed no difference in outcome related to transfusion. These conclusions need to be interpreted with caution as it is possible that smaller but clinically relevant differences in outcome may still exist, but they have not been demonstrated in this study due to the limited number of patients included. The strengths of this study are the secure randomisation of patients, no loss of patients to follow-up and full reporting of outcomes.
We did not exclude from this study those patients
Conflict of interest
The author does not have any conflict of interest with this article.
Source of funding
There was no external funding for this study.
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2020, InjuryCitation Excerpt :In hip fracture patients with a history of cardiac disease, a more liberal transfusion strategy decreases the risk of cardiovascular events, and for nursing home residents, a liberal strategy may reduce the prevalence of postoperative delirium [45–46]. If haemoglobin (Hb) is <8 g/dL, the patient should be cross-matched for two units of blood and transfused one, with subsequent Hb levels rechecked [22,43–44]. If the Hb is still <8 g/dL, the patient can be transfused with the second unit.
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