Retrospective Evaluation of a Restrictive Transfusion Strategy in Older Adults with Hip Fracture

Objectives To compare the association between a restrictive transfusion strategy and cardiovascular complications during hospitalization for hip fracture with the association between a liberal transfusion strategy and cardiovascular complications, accounting for all transfusions from the emergency d...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2018-07, Vol.66 (6), p.1151-1157
Main Authors: Zerah, Lorene, Dourthe, Lucile, Cohen‐Bittan, Judith, Verny, Marc, Raux, Mathieu, Mézière, Anthony, Khiami, Frédéric, Tourette, Cendrine, Neri, Christian, Le Manach, Yannick, Riou, Bruno, Vallet, Hélène, Boddaert, Jacques
Format: Article
Language:English
Subjects:
anemia
Cerebral infarction
Erythrocytes
Fibrillation
Fractures
Geriatrics
Health risk assessment
Heart diseases
Hemoglobin
Hip
hip fracture
Hip joint
Life Sciences
Medical prognosis
Myocardial infarction
older adults
Older people
prognosis
Rehabilitation
Stroke
transfusion
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Summary:Objectives To compare the association between a restrictive transfusion strategy and cardiovascular complications during hospitalization for hip fracture with the association between a liberal transfusion strategy and cardiovascular complications, accounting for all transfusions from the emergency department to postacute rehabilitation settings. Design Retrospective study. Setting Perioperative geriatric care unit. Participants All individuals aged 70 and older admitted to the emergency department for hip fracture and hospitalized in our perioperative geriatric care unit (N=667; n=193 in the liberal transfusion group, n=474 in the restrictive transfusion group) from July 2009 to April 2016. Intervention A restrictive transfusion strategy (hemoglobin level threshold ≥8 g/dL or symptoms) used from January 2012 to April 2016 was compared with the liberal transfusion strategy (hemoglobin level threshold ≥10 g/dL) used from July 2009 to December 2011. Measurements Primary endpoint was in‐hospital acute cardiovascular complications (heart failure, myocardial infarction, atrial fibrillation or stroke). Results The change to a restrictive transfusion strategy was associated with fewer acute cardiovascular complications (odds ratio=0.45, 95% confidence interval (CI)=0.31–0.67, p
ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.15371