Bone Abstracts

Introduction: The blood loss sustained during hip fracture repair can be significant and is associated with a high-risk of post-operative anaemia. Anaemia may exacerbate chronic cardiac and pulmonary conditions suffered by this aging population leading to increased morbidity and mortality.

Objective: To assess the prevalence and severity of anaemia throughout hospital admission in patients admitted with a fractured neck of femur.

Method: Data for haemoglobin levels of 100 consecutive patient admissions to the acute hip fracture ward in a UK district Hospital (Carmarthen, Wales, UK) were collected from a computer blood system. Patients’ haemoglobin levels (g/l) were collected; on admission, post-operatively and pre-discharge. The WHO guidelines for diagnosis of anaemia were used: <120 g/l for females and <130 g/l for males; severe anaemia (<80 g/l), moderate (between 80 and 100 g/l), mild (below normal range but >100 g/l).

Results: Sample: 100 hip fracture patients, 65% females. Average age: 80 years. The table shows the prevalence of anaemia. Average haemoglobin reductions of 26.4 g/l post-operatively and 12.9 g/l on discharge were recorded compared to admission. At discharge, 65 patients had a haemoglobin drop of at least 10 g/l compared to their admission level, 35 suffered a 20 g/l reduction or greater.

Conclusions: Anaemia on admission is common in hip fracture patients. Post operative anaemia following hip fracture repair is common, especially moderate anaemia. At time of discharge, high percentages of patients remain anaemic with some suffering substantial reductions in their haemoglobin level compared to admission. Further analysis to assess the effect of anaemia on morbidity, mortality and length of stay is required.