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Early surgery within 48 h was associated with reduced perioperative blood loss and red blood cell transfusion requirements in older patients with hip fracture: a retrospective study

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Key summary points

AbstractSection Aim

The aim of this study was to analyze the relationship between the timing of surgery and perioperative blood loss, red blood cell (RBC) transfusion rate, and RBC transfusion volume in older patients with hip fracture.

AbstractSection Findings

In this study, we found that older patients with hip fracture in the early surgery group had less total blood loss, less preoperative RBC transfusion rate, and less preoperative and perioperative RBC transfusion volume.

AbstractSection Message

Early surgery within 48 h was associated with reduced perioperative blood loss and red blood cell transfusion requirements in older patients with hip fracture.

Abstract

Purpose

The aim of this study was to analyze the relationship between the timing of surgery and perioperative blood loss, red blood cell (RBC) transfusion rate, and RBC transfusion volume in older patients with hip fracture.

Methods

From January 2020 to August 2022, this retrospective study enrolled older patients with hip fracture who underwent surgery in our hospital. The demographics, fracture type, type of surgery, time from injury to hospital, timing of surgery, medical history (hypertension, diabetes), duration of surgery, intraoperative blood loss, laboratory tests, and preoperative, postoperative and perioperative RBC transfusion requirements were recorded and analyzed. According to the surgical treatment within 48 h or after 48 h after admission, the patients were divided into early surgery group (ES) and delayed surgery group (DS).

Results

A total of 243 older patients with hip fracture were finally included in the study. Among these, 96 patients (39.51%) underwent surgery within 48 h of admission and 147 (60.49%) underwent surgery after this time. Total blood loss (TBL) in the ES group was lower than that in the DS group (576.03 ± 265.57 ml vs 699.26 ± 380.58 ml, P = 0.003). Preoperative RBC transfusion rate, and preoperative and perioperative RBC transfusion volume in the ES group were significantly lower than those in the DS group (15.63% vs 26.53%, P = 0.046; 50.00 ± 128.15 ml vs 117.01 ± 225.85 ml, P = 0.004; 80.21 ± 196.63 ml vs 144.90 ± 253.52 ml, P = 0.027).

Conclusion

Timing of surgery within 48 h of admission for older patients with hip fracture was associated with reduced the total blood loss and RBC transfusion requirements during the perioperative period.

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Funding

This study was supported by the National Natural Science Foundation of China (No. 81971160) and the Peking University Third Hospital Clinical Key Project Fund (No. BYSYZHKC2021106).

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Authors and Affiliations

  1. Department of Orthopedics, Peking University Third Hospital, No.49 North Garden Road, Haidian, 100191, Beijing, China

    Shilong Su, Ruideng Wang, Rubing Zhou, Zhengyang Chen & Fang Zhou

  2. Department of Orthopedics, The First Hospital of Changsha, No.311 Yingpan Road, Changsha, 410005, Hunan Province, China

    Yunqing Zhang

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  1. Shilong Su
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Contributions

FZ and SS conceived the original ideas of this manuscript. YZ, RW, RZ and ZC executed the follow-up examination and materials collection. SS, YZ and FZ read the examination results, participated in the surgical and medical treatment. SS prepared the manuscript and the figures. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Fang Zhou.

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Conflict of interest

Shilong Su, Yunqing Zhang, Ruideng Wang, Rubing Zhou, Zhengyang Chen and Fang Zhou declare that they have no conflict of interest.

Ethics approval and consent to participate

The study design was approved by the ethical committee of The First Hospital of Changsha. Permission to waive the informed consent was obtained from the institutional review board for this observational retrospective study.

Consent to publication

Permission to waive the informed consent was obtained from the institutional review board for this observational retrospective study.

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More data of the submission, including unpublished data will be available on reasonable request.

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Su, S., Zhang, Y., Wang, R. et al. Early surgery within 48 h was associated with reduced perioperative blood loss and red blood cell transfusion requirements in older patients with hip fracture: a retrospective study. Eur Geriatr Med 14, 1241–1248 (2023). https://doi.org/10.1007/s41999-023-00834-6

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