Systematic Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Jun 30, 2019; 7(6): 290-296
Published online Jun 30, 2019. doi: 10.13105/wjma.v7.i6.290
Relationship between perioperative anaemia and outcomes in older people with hip fractures: A systematic review and meta-analysis protocol
Kareeann SF Khow, Michelle WK Kee, Pazhvoor N Shibu, Solomon CY Yu, Mellick J Chehade, Renuka Visvanathan
Kareeann SF Khow, Michelle WK Kee, Pazhvoor N Shibu, Solomon CY Yu, Renuka Visvanathan, Aged and Extended Care Services, the Queen Elizabeth Hospital, Woodville South, SA 5011, Australia
Kareeann SF Khow, Pazhvoor N Shibu, Solomon CY Yu, Renuka Visvanathan, Centre of Research Excellence, Frailty Trans-disciplinary Research to Achieve Healthy Ageing, University of Adelaide, Adelaide, SA 5005, Australia
Mellick J Chehade, Discipline of Orthopaedics and Trauma, Faculty of Medical and Health Sciences, University of Adelaide, Adelaide, SA 5005, Australia
Author contributions: Khow KSF, Kee MWK, Shibu PN, Yu SCY, Chehade MJ and Visvanathan R contributed equally to the work; Khow KSF conceptualized and designed the review together with Kee MWK; Khow KSF drafted the initial paper; all authors reviewed and approved the final manuscript as submitted.
Conflict-of-interest statement: Dr Shibu has received educational grants and honoraria from Novartis Pty Australia and Amgen Pty Ltd. Associate Professor Chehade has received institutional research grant from Stryker and Amgen Pty Ltd. Professor Visvanathan has participated in international initiatives funded by educational grants from Nestle and has presented at symposiums funded by Nestle. She is on the Malnutrition in the Elderly Board with Nestle Australia. Dr Khow, Dr Kee and Associate Professor Yu do not have any conflict of interests.
PRISMA 2009 Checklist statement: The manuscript is designed as per PRISMA 2009 guideline, and checklist is provided as supplementary file.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Kareeann SF Khow, FRACP, MBChB, Research Fellow, Senior Lecturer, Staff Physician, Aged and Extended Care Services, the Queen Elizabeth Hospital, 28 Woodville Road, Woodville South, SA 5011, Australia.
Telephone: +61-8-83132144 Fax: +61-8-83132155
Received: April 28, 2019
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
Research background

Perioperative anaemia in hip fracture is a common problem that can influence clinical outcomes. However, it is uncertain which outcomes will be affected and if anaemia before or after surgery will have different effects.

Research motivation

A better understanding of how perioperative anaemia influences clinical outcomes after hip fracture surgery will help to develop more timely interventions.

Research objectives

To determine the effects of perioperative anaemia during hip fracture surgery on mortality, hospital length of stay, postoperative complications, hospital readmission, change of discharge destination, quality of life and functional status.

Research methods

Electronic databases will be searched for studies evaluating perioperative anaemia and outcomes of hip fracture surgery. Data on study characteristics, patient demographics, timing of anaemia and clinical outcomes will be extracted. Comparison will be made between participants with anaemia and those without. Data will be pooled for meta-analysis for the primary outcome.

Research conclusions

This systematic review seeks to clarify the outcomes associated with perioperative anaemia at various time-points among patients who had hip fracture surgery. An evaluation of the outcomes associated with perioperative anaemia in hip fracture surgery will potentially inform evidence-based clinical practice on the effectiveness and timing of interventions in those with reduced haemoglobin.

Research perspectives

In presence of small studies evaluating perioperative anaemia among older people having hip fracture surgery, a systematic review and meta-analysis will provide important directions for future research and clinical practice in this field. This protocol will provide an important methodological foundation for the systematic review.