Rown Parola1, Sanjit R Konda1,2, Cody R Perskin1, Abhishek Ganta1,2, Kenneth A Egol3,4. 1. Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA. 2. Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Jamaica, NY, USA. 3. Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA. Kenneth.Egol@nyulangone.org. 4. Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Jamaica, NY, USA. Kenneth.Egol@nyulangone.org.
Abstract
PURPOSE: The purpose of this study is to determine the effects of blood transfusion timing in hip fracture patients. METHODS: A consecutive series of hip fracture patients 55 years and older who required a blood transfusion during hospitalization were reviewed for demographic, injury, clinical outcome, and cost information. A validated risk predictive score (STTGMA) was calculated for each patient. Patients were stratified to preoperative, intraoperative, or postoperative first transfusion cohorts. The intraoperative and postoperative cohorts were matched by STTGMA, sex, and procedure to the preoperative cohort. Baseline patient characteristics and outcomes were compared before and after matching. RESULTS: Prior to matching, the preoperative cohort was more often male (p < 0.001) with increased Charlson comorbidity index (p = 0.012), ASA class (p < 0.002), STTGMA (p < 0.001), total transfused volume (p = 0.002), incidence of inpatient mortality (p = 0.045), myocardial infarction (p = 0.005) and cardiac arrest (p = 0.014). After matching, the preoperative cohort had increased total transfused volume (p = 0.015) and decreased pneumonia incidence (p = 0.040). CONCLUSION: Matching STTGMA score, sex, and procedure results in non-inferior outcomes among hip fracture patients receiving preoperative first blood transfusions compared to intraoperative and postoperative transfusions.
PURPOSE: The purpose of this study is to determine the effects of blood transfusion timing in hip fracture patients. METHODS: A consecutive series of hip fracture patients 55 years and older who required a blood transfusion during hospitalization were reviewed for demographic, injury, clinical outcome, and cost information. A validated risk predictive score (STTGMA) was calculated for each patient. Patients were stratified to preoperative, intraoperative, or postoperative first transfusion cohorts. The intraoperative and postoperative cohorts were matched by STTGMA, sex, and procedure to the preoperative cohort. Baseline patient characteristics and outcomes were compared before and after matching. RESULTS: Prior to matching, the preoperative cohort was more often male (p < 0.001) with increased Charlson comorbidity index (p = 0.012), ASA class (p < 0.002), STTGMA (p < 0.001), total transfused volume (p = 0.002), incidence of inpatient mortality (p = 0.045), myocardial infarction (p = 0.005) and cardiac arrest (p = 0.014). After matching, the preoperative cohort had increased total transfused volume (p = 0.015) and decreased pneumonia incidence (p = 0.040). CONCLUSION: Matching STTGMA score, sex, and procedure results in non-inferior outcomes among hip fracture patients receiving preoperative first blood transfusions compared to intraoperative and postoperative transfusions.
Authors: Jeffrey L Carson; Michael L Terrin; Helaine Noveck; David W Sanders; Bernard R Chaitman; George G Rhoads; George Nemo; Karen Dragert; Lauren Beaupre; Kevin Hildebrand; William Macaulay; Courtland Lewis; Donald Richard Cook; Gwendolyn Dobbin; Khwaja J Zakriya; Fred S Apple; Rebecca A Horney; Jay Magaziner Journal: N Engl J Med Date: 2011-12-14 Impact factor: 91.245
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Authors: Markus M Mueller; Hans Van Remoortel; Patrick Meybohm; Kari Aranko; Cécile Aubron; Reinhard Burger; Jeffrey L Carson; Klaus Cichutek; Emmy De Buck; Dana Devine; Dean Fergusson; Gilles Folléa; Craig French; Kathrine P Frey; Richard Gammon; Jerrold H Levy; Michael F Murphy; Yves Ozier; Katerina Pavenski; Cynthia So-Osman; Pierre Tiberghien; Jimmy Volmink; Jonathan H Waters; Erica M Wood; Erhard Seifried Journal: JAMA Date: 2019-03-12 Impact factor: 56.272