Published online Jun 30, 2019. doi: 10.13105/wjma.v7.i6.290
Peer-review started: April 28, 2019
First decision: May 9, 2019
Revised: June 1, 2019
Accepted: June 17, 2019
Article in press: June 17, 2019
Published online: June 30, 2019
Hip fractures are common with increasing age and is associated with decline in mobility. Both the fracture and the surgery can lead to blood loss, resulting in anaemia. However, it is uncertain at which time point haemoglobin is most strongly associated with different clinical outcomes after hip fracture. Our hypothesis is perioperative anaemia (admission, postoperative and discharge) during hip fracture surgery is associated with poor clinical outcomes.
To determine the effects of perioperative anaemia during hip fracture surgery on mortality, functional status and other clinical outcomes.
Electronic databases will be searched to identify studies evaluating perioperative anaemia and outcomes of hip fracture surgery. Reference lists of included studies will also be searched to identify additional published studies. Eligibility criteria are as follows: Population: People who underwent hip fracture surgery; Exposure: Perioperative anaemia; Comparison: No anaemia before or after hip fracture surgery; Outcome: Mortality, hospital length of stay, postoperative complications, hospital readmission, change of discharge destination, quality of life and functional status. Risk of bias assessment will be assessed using the Cochrane Collaboration’s tool for randomized controlled trials and the modified version of the Epidemiological Appraisal Instrument for observational studies. Data will be pooled for meta-analysis if deemed appropriate.
This review seeks to clarify outcomes associated with perioperative anaemia at various time-points around hip fracture surgery. These findings will potentially inform evidence-based clinical practice on interventions in those with anaemia.
Core tip: Hip fracture is a growing public health problem because of population aging. Recovery from hip fracture can be slow and complicated by morbidities and decline in functional abilities. Perioperative anaemia is common with hip fractures. However, it is uncertain at which time point haemoglobin level is most strongly associated with different clinical outcomes after hip fracture surgery. Better understanding of the relationship between perioperative haemoglobin and mortality, length of hospital stay, functional status, postoperative complications, hospital readmission and admission to residential care after discharge, is required.