The relationship between admission hemoglobin level and outcome after hip fracture.
OBJECTIVE
To determine the effect of admission hemoglobin level on patient outcome after hip fracture.


METHODS
Prospective, consecutive.


METHODS
From July 1991 to June 1997, 395 community-dwelling patients sixty-five years of age or older who had sustained an operatively treated femoral neck or intertrochanteric fracture were prospectively followed up.


METHODS
Postoperative complications, in-hospital mortality rate, hospital length of stay, hospital discharge status, place of residence at one year, and mortality and recovery of ambulatory ability and activities of daily living status at three, six, and twelve months.


RESULTS
Women with admission hemoglobin levels below 12.0 grams per deciliter and men with admission hemoglobin levels below 13.0 grams per deciliter were classified as anemic. One hundred eighty patients (45.6 percent) were considered anemic on admission. Patients who were anemic were more likely to have an American Society of Anesthesiologists rating of III or IV and have sustained an intertrochanteric fracture. Hospital length of stay and mortality rate at six and twelve months were significantly higher for patients who were anemic on admission. There were no differences in the incidence of postoperative complications, hospital discharge status, place of residence at one year, in-hospital mortality rate, and three-month mortality rate between patients who were and were not anemic on admission. In addition, there were no differences in the recovery of ambulatory ability and of basic and instrumental activities of daily living status at three, six, and twelve months between the two patient groups.


CONCLUSIONS
Patients at risk for poor outcomes after hip fracture can be identified by assessing hemoglobin levels at hospital admission.
Gruson
Konrad I
KI
Geriatric Hip Fracture Research Group, Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York, New York 10003, USA.
Aharonoff
Gina B
GB
Egol
Kenneth A
KA
Zuckerman
Joseph D
JD
Koval
Kenneth J
KJ
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005265:Femoral Neck Fractures / Q000097:blood / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006454:Hemoglobins / Q000032:analysis*; D006620:Hip Fractures / Q000097:blood / Q000601:surgery*; D006801:Humans; D008297:Male; D010343:Patient Admission; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011336:Probability; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome
D006454:Hemoglobins