Intravenous Iron May Improve Outcomes in Elderly Patients With Operative Hip Fractures

Engel, Jamie L.; Gabra, Joseph N.; Kane, Philip; Kurtz, William J

doi:10.1177/2151459320911844

Cited by 6 publications

(11 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After study selection, according to our predefined protocol, 36 fulltext manuscripts were reviewed and from these 13 studies, 3718 patients were suitable for inclusion in the review. [23][24][25][26][27][28][29][30][31][32][33][34][35] (Figure 1) The studies excluded after full-text review are presented in Supporting Information S1. Of the included studies, four were randomized trials (732 patients) 23,25,28,32 and nine were nonrandomized studies (2986 patients).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies, two RCTs 25 , 35 (456 participants) and one nonrandomized study 32 (1634 participants) reported discharge hemoglobin. While a difference was demonstrated in discharge hemoglobin in the nonrandomized study, there was no difference in discharge hemoglobin between groups in the RCT (Supporting Information: Figure S6 ).…”

Section: Methodsmentioning

confidence: 99%

“…Three studies, two RCTs 25,35 (456 participants) and one nonrandomized study 32 (1634 participants) reported discharge hemoglobin.…”

Section: Discharge Hemoglobinmentioning

confidence: 99%

See 2 more Smart Citations

Perioperative intravenous iron to treat patients with fractured hip surgery: A systematic review and meta‐analysis

Sinclair

Bowman

Moppett

et al. 2022

Health Science Reports

View full text Add to dashboard Cite

Background: Treatment of preoperative anemia with intravenous iron is common within elective surgical care pathways. It is plausible that this treatment may improve care for people with hip fractures many of whom are anemic because of pre-existing conditions, fractures, and surgery.Objective: To review the evidence for intravenous iron administration on outcomes after hip fracture.Design: We followed a predefined protocol and conducted a systematic review and meta-analysis of the use of intravenous iron to treat anemia before and after emergency hip fracture surgery. The planned primary outcome was a difference in length of stay between those treated with intravenous iron and the control group. Other outcomes analyzed were 30-day mortality, requirement for blood transfusion, changes in quality of life, and hemoglobin concentration on discharge from the hospital. Data Sources: EMBASE, MEDLINE, The Cochrane Library (CENTRAL, DARE) databases, Clinicaltrials.gov, and ISRCTN trial registries. Date of final search March 2022. Eligibility Criteria: Adult patients undergoing urgent surgery for hip fracture. Studies considered patients who received intravenous iron and were compared with a control group.Results: Four randomized controlled trials (RCT, 732 patients) and nine cohort studies (2986 patients) were included. The RCTs were at low risk of bias, and the nonrandomized studies were at moderate risk of bias. After metanalysis of the RCTs there was no significant difference in the primary outcome, length of hospital stay, between the control group and patients receiving intravenous iron (mean difference: −0.59, 95% confidence interval [CI]; −1.20 to 0.03; I 2 = 30%, p = 0.23). Intravenous iron was not associated with a difference in 30-day mortality (n = 732, OR: 1.14, 95% CI: 0.62−2.1; I 2 = 0%, p = 0.50), nor with the requirement for transfusion (n = 732, OR: 0.85, 95% CI: 0.63−1.14; I 2 = 0%, p < 0.01) in the analyzed RCTs. Functional outcomes and quality of life were variably reported in three studies. Conclusion:The evidence on the use of intravenous iron in patients with hip fracture is low quality and shows no difference in length of acute hospital stay and transfusion requirements in this population. Improved large, multicentre, high-quality studies with

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Perioperative intravenous iron to treat patients with fractured hip surgery: A systematic review and meta‐analysis

Sinclair

Bowman

Moppett

et al. 2022

Health Science Reports

View full text Add to dashboard Cite

show abstract

“…Several studies found that up to 70% of the these patients need perioperative allogeneic blood transfusion [14,26]. It is described that the major factors that have an in uence to receive blood transfusion are age, comorbidities, type of fracture and surgery performed (extracapsular fractures treated with intramedullary nailing are the cause of more anaemia) [26], the type of surgery performed and the haemoglobin concentration at admission [7,14]. Close monitoring of patients and presurgical optimization have made that in our sample the level of blood transfusions have increased from 27.2% in 2012 to 53.1% in 2017.…”

Section: Discussionmentioning

confidence: 99%

Influence of Orthogeriatrics on the Morbidity and Mortality of Patients with Hip Fracture.

Balvís-Balvís¹,

Domínguez-Prado²,

Ferradas-Garcia³

et al. 2020

Preprint

View full text Add to dashboard Cite

BACKGROUND: Osteoporotic hip fractures often occur in fragile, elderly patients and are associated with a significant morbidity and mortality. The objective of this study is to evaluate the morbidity and mortality together with the length of hospital stay in patients with hip fracture in two non-consecutive years and to compare their evolution with the involvement of a specialist in orthogeriatric care.MATERIAL AND METHODS: Retrospective study that reviewed a total of 633 patients with an average age of 85.5 years who suffered a hip fracture and were treated in the same service of Trauma and Orthopaedics in two different years (2012 and 2017). We have analysed mortality, morbidity during their hospital stay, the length of hospital stays and the cost-benefit after the implication of a specialist in orthogeriatric care in 2017.RESULTS: Mortality during their hospital stay decreased significantly from 10% in 2012 to 3.6% in 2017. We have also observed a decrease in mortality at 30 days (10.5% versus 7%) and after one year (28.9% versus 24.9%) between both groups, although these differences were not statistically significant. The length of hospital stays decreased significantly between both periods observed. The average stay decreased by 4.8 days, the surgical delay decreased by 1.1 days and the postoperative hospital stay decreased by 3.4 days. The total annual economic savings estimated due to the involvement of a geriatrician in the follow-up of patients with hip fracture was 1,017.084.94€.CONCLUSIONS: The multidisciplinary approach of patients with hip fracture results in a more effective and more efficient care model. The quality of care and the clinical care optimisation of patients in the perioperative period improve and both hospital stay and mortality during hospital stay decrease significantly. A significant economic saving is also obtained in the treatment of this pathology.

show abstract

“…A Spanish randomized controlled trial conducted in 2005, showed that in certain subgroups peri-operative iron infusions decrease the requirements for later RBC transfusion and reduce rates of nosocomial infections [18]. A recent US study has shown that the use of IV iron decreases length of hospital stay and readmission rates in hip fracture patients [19]. However, there is a need for further research in this area.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Frequency, Investigation, and Management of Post-operative Anaemia in Hip Fracture Patients

McCormack

Costigan

McGarry

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundPost-operative anaemia affects up to 90% of patients undergoing major surgery [1]. Post-operative anaemia can contribute to slower rehabilitation, increased morbidity, and increased mortality [2]. AimsWe aimed to examine the frequency, investigation, and management of anaemia in patients admitted to St. Vincent’s University Hospital (SVUH) with a hip fracture.MethodsA retrospective audit, examining all patients who were admitted to SVUH with a hip fracture between the 1st of April and the 30th of June 2020, was performed. ResultsA total of 58 patients were included. Upon admission, 29.3% (n = 17) of patients were anaemic. Post-operatively, 91.4% of patients (n = 53) were anaemic. 43.1% (n = 25) of patients had iron studies, ferritin, folate and B12 levels measured. Iron deficiency anaemia was detected in 22.4% (n = 13) of patients, folate deficiency was detected in 10.3% (n = 6), and no patients were found to have vitamin B12 deficiency. Of the patients with iron deficiency anaemia, 15.4% (n = 2) were given IV iron infusions and 7.7% (n = 1) received a prescription for oral iron. Of the 6 patients with folate deficiency, 33.3% (n = 2) received a prescription for folic acid. Red cell transfusions were given to 13.8% (n = 8) of patients. Upon discharge, 89.7% (n = 52) of patients remained anaemic. ConclusionsAnaemia is an under-investigated and under-treated complication of hip fractures.

show abstract

Intravenous Iron May Improve Outcomes in Elderly Patients With Operative Hip Fractures

Cited by 6 publications

References 23 publications

Perioperative intravenous iron to treat patients with fractured hip surgery: A systematic review and meta‐analysis

Perioperative intravenous iron to treat patients with fractured hip surgery: A systematic review and meta‐analysis

Influence of Orthogeriatrics on the Morbidity and Mortality of Patients with Hip Fracture.

Assessing the Frequency, Investigation, and Management of Post-operative Anaemia in Hip Fracture Patients

Contact Info

Product

Resources

About