[Perioperative anaemia in geriatric patients with hip fracture].
OBJECTIVE
To describe and study the effectiveness of the perioperative anaemia treatment patterns for patients older than 64 with hip fracture.


METHODS
Three groups of patients were compared: Group 1: Oral iron or without iron therapy. Group 2: low doses of intravenous iron. Group 3: treated according to a blood saving programme including intravenous iron, alpha epoetin and restrictive transfusional criteria. The homogeneity of gender, age, type of fracture, ASA, preoperative period and perisurgical bleeding affecting drug consumption within the groups was analyzed. The effectiveness of the treatments was determined by means of transfusional rate, postoperative haemoglobin levels, and postoperative length of stay and infection rate.


RESULTS
329 patients were checked. Patients were comparable. Patients included in Group 3 were transfused less than the rest (36.5 of patients in group 3 vs. 52.0% in group 1 and 67.6% in group 3, p = 0.002). Decreases in the infection rate and mean postoperative stay in group 3 were not significant. Haemoglobin levels at 48 hours post surgery were higher in group 1 but haemoglobin levels at the seventh day post surgery were similar for the three groups.


CONCLUSIONS
The above mentioned blood saving programme has been observed to be effective in decreasing transfusional requirements without increasing morbidity. However, further prospective studies are needed in order to define the cost-effectiveness of this programme and to determine its role in the reduction of posttransfusional infections and postoperative length of stay.
Izuel-Rami
M
M
Servicio de Farmacia, Hospital Universitario Miguel Servet, Zaragoza. mizuel@salud.aragon.es
Cuenca Espiérrez
J
J
García-Erce
J A
JA
Gómez-Barrera
M
M
Carcelén Andrés
J
J
Rabanaque Hernández
M J
MJ
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006620:Hip Fractures / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007501:Iron / Q000627:therapeutic use*; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000188:drug therapy* / Q000453:epidemiology; D011300:Preoperative Care; D011994:Recombinant Proteins; D012189:Retrospective Studies
D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa; D007501:Iron