Blood transfusion rates and predictors following geriatric hip fracture surgery
Background: Postoperative blood product transfusions in elderly hip fracture patients cause concern for morbidity and mortality. The purpose of this study was to identify predictors and short-term sequelae of postoperative transfusion following geriatric hip fracture surgery. Methods: We queried the...
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| Veröffentlicht in: | Hip international 2021-03, Vol.31 (2), p.272-279 |
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| creator | Arshi, Armin Lai, Wilson C Iglesias, Brenda C McPherson, Edward J Zeegen, Erik N Stavrakis, Alexandra I Sassoon, Adam A |
| description | Background:
Postoperative blood product transfusions in elderly hip fracture patients cause concern for morbidity and mortality. The purpose of this study was to identify predictors and short-term sequelae of postoperative transfusion following geriatric hip fracture surgery.
Methods:
We queried the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to identify geriatric (⩾65 years) patients who sustained operative femoral neck, intertrochanteric, and subtrochanteric hip fractures in 2016. Multivariate regression was used to determine risk-adjusted odds ratios (OR) of associated perioperative risk factors and sequelae of postoperative transfusion.
Results:
In total, 8416 geriatric hip fracture patients were identified of whom 28.3% had documented postoperative transfusion. In multivariate analysis, age (OR 1.03 [1.02–1.04], p |
| doi_str_mv | 10.1177/1120700019897878 |
| format | Article |
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Postoperative blood product transfusions in elderly hip fracture patients cause concern for morbidity and mortality. The purpose of this study was to identify predictors and short-term sequelae of postoperative transfusion following geriatric hip fracture surgery.
Methods:
We queried the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to identify geriatric (⩾65 years) patients who sustained operative femoral neck, intertrochanteric, and subtrochanteric hip fractures in 2016. Multivariate regression was used to determine risk-adjusted odds ratios (OR) of associated perioperative risk factors and sequelae of postoperative transfusion.
Results:
In total, 8416 geriatric hip fracture patients were identified of whom 28.3% had documented postoperative transfusion. In multivariate analysis, age (OR 1.03 [1.02–1.04], p < 0.001), preoperative anaemia (OR 4.69 [3.99–5.52], p = 0.001), female sex (OR 1.61 [1.39–1.87], p < 0.001), lower BMI (OR 0.97 [0.96–0.98], p < 0.001), American Society of Anesthesiologists (ASA) classification (OR 1.14 [1.01–1.27], p = 0.031), COPD (OR 1.30 [1.06–1.59], p = 0.011), hypertension (OR 1.17 [1.01–1.35], p = 0.038), increased OR time (OR 1.02 [1.01–1.03], p < 0.001), and intertrochanteric (OR 2.99 [2.57–3.49], p < 0.001) and subtrochanteric femur fractures (OR 5.07 [3.84–6.69], p < 0.001) were independent risk factors for receiving postoperative blood transfusion. Patients with postoperative transfusion had a significantly higher risk-adjusted 30-day mortality (8.4% vs. 6.4%, OR 1.29 [1.02–1.64], p = 0.035), hospital readmission rate (9.4% vs. 7.7%, OR 1.27 [1.04–1.55], p = 0.018), and total hospital LOS (7.3 vs. 6.3 days, p < 0.001).
Conclusions:
Postoperative transfusion is a common occurrence in geriatric fragility hip fractures with multiple risk factors. Careful preoperative planning and multidisciplinary management efforts are warranted to reduce use of postoperative transfusions.]]></description><identifier>ISSN: 1120-7000</identifier><identifier>EISSN: 1724-6067</identifier><identifier>DOI: 10.1177/1120700019897878</identifier><identifier>PMID: 31912747</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Blood Transfusion ; Female ; Hip Fractures - surgery ; Humans ; Patient Readmission ; Pelvic Bones ; Postoperative Complications - epidemiology ; Retrospective Studies ; Risk Factors</subject><ispartof>Hip international, 2021-03, Vol.31 (2), p.272-279</ispartof><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-1889092fc8f5a7ceffc464cab033b75e241235b359bd006885e7e67528f4c6743</citedby><cites>FETCH-LOGICAL-c337t-1889092fc8f5a7ceffc464cab033b75e241235b359bd006885e7e67528f4c6743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1120700019897878$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1120700019897878$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31912747$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arshi, Armin</creatorcontrib><creatorcontrib>Lai, Wilson C</creatorcontrib><creatorcontrib>Iglesias, Brenda C</creatorcontrib><creatorcontrib>McPherson, Edward J</creatorcontrib><creatorcontrib>Zeegen, Erik N</creatorcontrib><creatorcontrib>Stavrakis, Alexandra I</creatorcontrib><creatorcontrib>Sassoon, Adam A</creatorcontrib><title>Blood transfusion rates and predictors following geriatric hip fracture surgery</title><title>Hip international</title><addtitle>Hip Int</addtitle><description><![CDATA[Background:
Postoperative blood product transfusions in elderly hip fracture patients cause concern for morbidity and mortality. The purpose of this study was to identify predictors and short-term sequelae of postoperative transfusion following geriatric hip fracture surgery.
Methods:
We queried the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to identify geriatric (⩾65 years) patients who sustained operative femoral neck, intertrochanteric, and subtrochanteric hip fractures in 2016. Multivariate regression was used to determine risk-adjusted odds ratios (OR) of associated perioperative risk factors and sequelae of postoperative transfusion.
Results:
In total, 8416 geriatric hip fracture patients were identified of whom 28.3% had documented postoperative transfusion. In multivariate analysis, age (OR 1.03 [1.02–1.04], p < 0.001), preoperative anaemia (OR 4.69 [3.99–5.52], p = 0.001), female sex (OR 1.61 [1.39–1.87], p < 0.001), lower BMI (OR 0.97 [0.96–0.98], p < 0.001), American Society of Anesthesiologists (ASA) classification (OR 1.14 [1.01–1.27], p = 0.031), COPD (OR 1.30 [1.06–1.59], p = 0.011), hypertension (OR 1.17 [1.01–1.35], p = 0.038), increased OR time (OR 1.02 [1.01–1.03], p < 0.001), and intertrochanteric (OR 2.99 [2.57–3.49], p < 0.001) and subtrochanteric femur fractures (OR 5.07 [3.84–6.69], p < 0.001) were independent risk factors for receiving postoperative blood transfusion. Patients with postoperative transfusion had a significantly higher risk-adjusted 30-day mortality (8.4% vs. 6.4%, OR 1.29 [1.02–1.64], p = 0.035), hospital readmission rate (9.4% vs. 7.7%, OR 1.27 [1.04–1.55], p = 0.018), and total hospital LOS (7.3 vs. 6.3 days, p < 0.001).
Conclusions:
Postoperative transfusion is a common occurrence in geriatric fragility hip fractures with multiple risk factors. Careful preoperative planning and multidisciplinary management efforts are warranted to reduce use of postoperative transfusions.]]></description><subject>Aged</subject><subject>Blood Transfusion</subject><subject>Female</subject><subject>Hip Fractures - surgery</subject><subject>Humans</subject><subject>Patient Readmission</subject><subject>Pelvic Bones</subject><subject>Postoperative Complications - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>1120-7000</issn><issn>1724-6067</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LAzEYhIMotlbvniRHL6v53CRHLfUDCr3oeclmk5qy3azJLtJ_b0qrB8HT-8I8MzADwDVGdxgLcY8xQQIhhJVUQgp5AqZYEFaUqBSn-c9ysdcn4CKlDUKEKM7OwYRihYlgYgpWj20IDRyi7pIbkw8djHqwCequgX20jTdDiAm60Lbhy3druLbR6yF6Az98D13UZhijhWmMWdldgjOn22SvjncG3p8Wb_OXYrl6fp0_LAtDqRgKLKVCijgjHdfCWOcMK5nRNaK0FtwShgnlNeWqbhAqpeRW2FJwIh0zpWB0Bm4PuX0Mn6NNQ7X1ydi21Z0NY6oIpSw350RlFB1QE0NK0bqqj36r467CqNrPWP2dMVtujuljvbXNr-FntwwUByDpta02YYxdbvt_4DcpiHoU</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Arshi, Armin</creator><creator>Lai, Wilson C</creator><creator>Iglesias, Brenda C</creator><creator>McPherson, Edward J</creator><creator>Zeegen, Erik N</creator><creator>Stavrakis, Alexandra I</creator><creator>Sassoon, Adam A</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202103</creationdate><title>Blood transfusion rates and predictors following geriatric hip fracture surgery</title><author>Arshi, Armin ; Lai, Wilson C ; Iglesias, Brenda C ; McPherson, Edward J ; Zeegen, Erik N ; Stavrakis, Alexandra I ; Sassoon, Adam A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-1889092fc8f5a7ceffc464cab033b75e241235b359bd006885e7e67528f4c6743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Blood Transfusion</topic><topic>Female</topic><topic>Hip Fractures - surgery</topic><topic>Humans</topic><topic>Patient Readmission</topic><topic>Pelvic Bones</topic><topic>Postoperative Complications - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arshi, Armin</creatorcontrib><creatorcontrib>Lai, Wilson C</creatorcontrib><creatorcontrib>Iglesias, Brenda C</creatorcontrib><creatorcontrib>McPherson, Edward J</creatorcontrib><creatorcontrib>Zeegen, Erik N</creatorcontrib><creatorcontrib>Stavrakis, Alexandra I</creatorcontrib><creatorcontrib>Sassoon, Adam A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hip international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arshi, Armin</au><au>Lai, Wilson C</au><au>Iglesias, Brenda C</au><au>McPherson, Edward J</au><au>Zeegen, Erik N</au><au>Stavrakis, Alexandra I</au><au>Sassoon, Adam A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blood transfusion rates and predictors following geriatric hip fracture surgery</atitle><jtitle>Hip international</jtitle><addtitle>Hip Int</addtitle><date>2021-03</date><risdate>2021</risdate><volume>31</volume><issue>2</issue><spage>272</spage><epage>279</epage><pages>272-279</pages><issn>1120-7000</issn><eissn>1724-6067</eissn><abstract><![CDATA[Background:
Postoperative blood product transfusions in elderly hip fracture patients cause concern for morbidity and mortality. The purpose of this study was to identify predictors and short-term sequelae of postoperative transfusion following geriatric hip fracture surgery.
Methods:
We queried the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to identify geriatric (⩾65 years) patients who sustained operative femoral neck, intertrochanteric, and subtrochanteric hip fractures in 2016. Multivariate regression was used to determine risk-adjusted odds ratios (OR) of associated perioperative risk factors and sequelae of postoperative transfusion.
Results:
In total, 8416 geriatric hip fracture patients were identified of whom 28.3% had documented postoperative transfusion. In multivariate analysis, age (OR 1.03 [1.02–1.04], p < 0.001), preoperative anaemia (OR 4.69 [3.99–5.52], p = 0.001), female sex (OR 1.61 [1.39–1.87], p < 0.001), lower BMI (OR 0.97 [0.96–0.98], p < 0.001), American Society of Anesthesiologists (ASA) classification (OR 1.14 [1.01–1.27], p = 0.031), COPD (OR 1.30 [1.06–1.59], p = 0.011), hypertension (OR 1.17 [1.01–1.35], p = 0.038), increased OR time (OR 1.02 [1.01–1.03], p < 0.001), and intertrochanteric (OR 2.99 [2.57–3.49], p < 0.001) and subtrochanteric femur fractures (OR 5.07 [3.84–6.69], p < 0.001) were independent risk factors for receiving postoperative blood transfusion. Patients with postoperative transfusion had a significantly higher risk-adjusted 30-day mortality (8.4% vs. 6.4%, OR 1.29 [1.02–1.64], p = 0.035), hospital readmission rate (9.4% vs. 7.7%, OR 1.27 [1.04–1.55], p = 0.018), and total hospital LOS (7.3 vs. 6.3 days, p < 0.001).
Conclusions:
Postoperative transfusion is a common occurrence in geriatric fragility hip fractures with multiple risk factors. Careful preoperative planning and multidisciplinary management efforts are warranted to reduce use of postoperative transfusions.]]></abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>31912747</pmid><doi>10.1177/1120700019897878</doi><tpages>8</tpages></addata></record> |
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| ispartof | Hip international, 2021-03, Vol.31 (2), p.272-279 |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Aged Blood Transfusion Female Hip Fractures - surgery Humans Patient Readmission Pelvic Bones Postoperative Complications - epidemiology Retrospective Studies Risk Factors |
| title | Blood transfusion rates and predictors following geriatric hip fracture surgery |
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